Objective To investigate the effect of narrative education on emotional and clinical ability of baccalaureate nursing students practicing in ICU. Methods A total of 42 baccalaureate nursing students practicing in ICU between January 2016 and September 2016 were treated as the control group and received traditional teaching, their counterparts practicing in ICU between October 2016 and June 2017 were served as the observation group (41 cases) and subject to narrative education. The Self-rating Anxiety Scale(SAS),the Self-rating Depression Scale(SDS) were filled out by both groups before and after practicing in ICU, and assessed the comprehensive ability after ICU practice. Results The scores of SAS and SDS after practicing were (49.47 ± 12.37),(50.25 ± 11.86)points in the observation group and (54.32 ± 12.51), (55.79 ± 11.34) points in the control group, and the difference was significant(t=10.822, 12.310, P<0.05). The total scores and personal quality, theoretical knowledge level, clinical nursing ability, judgment thinking ability, communication and cooperation ability was (88.45 ± 13.54), (23.21 ± 4.73), (18.42±3.45), (17.91±3.62), (8.56±0.83), (8.34±0.67) points in the observation group , and (73.13± 11.35), (19.13±4.52), (15.45±3.21), (15.76±3.54), (6.17±0.19), (5.17±0.18) points in the control group, and the difference was significant (t=3.226-8.665, P<0.05 or 0.01). Conlusions The narration education can reduce the psychological burden of baccalaureate nursing students practicing in ICU and can improve the comprehensive ability of them.

Objective To explore the influence of homogeneity management on ICU nurses' clinical practice ability, job satisfaction and patient safety. Methods Shanghai Tenth People's Hospital implemented the homogeneity management from January 2016, through training, empowerment and optimization scheduling. A total of 30 ICU nurses were investigated for their clinical practice ability, job satisfaction and nursing adverse events. Data were collected from the results of Clinical Practice Ability Questionnaire and Job Satisfaction Questionnaire, and were used to analysis the differences before and after the homogeneity management. Results After the homogeneity management implementation the score of clinical practice ability of the ICU nurses raised to (84.77±3.80), which was (71.63±5.19) before,the difference was statistically significant (t=-11.181, P<0.01). The score of job satisfaction increased from (17.20±1.84) to (22.43±3.00), the difference was statistically significant (t=-8.454, P< 0.01). There were 2 cases of catheter slippage in 2016, and the incidence of nursing adverse events is 0.15% (2/1 300). Conclusions Homogeneity management can effectively improve the clinical practice ability and job satisfaction of nurses, reduce the incidence of nursing adverse events, and provide guarantee for the safety of patients.

Patients with malignant tumor of digestive tract often suffer from malnutrition, which is not only a risk factor for surgery, radiotherapy and chemotherapy, but also affects the prognosis of patients. Early nutrition assessment helps to promptly identify patients with malnutrition and nutritional risks. Nutritional interventions for such patients can effectively change the clinical progress of patients, reduce the incidence of complications, and improve the prognosis of patients. This article will review different nutrition screening and assessment tools in order to provide a reference for clinical nutrition assessment.

This paper reviewed research tools of pressure, pressure source, signs and symptoms, and coping styles of male nurses. Effective strategies for male nurses to cope with stress had been proposed, to instruct male nurses to master and apply pressure management methods, improve mental health, and provide basis for managers to take countermeasures at the same time.

This paper summarizes the concept of male nurses' willingness to quit and tools for measuring the willingness to quit. It is suggested there are three aspects to reduce the turnover rate of male nurses: individual factors; social supporting factors; and organizational management factors. Comprehensive interventions, such as, using professional training to cope with the impact of transition shock on the psychological capital of male nurses, creating supportive atmosphere to reduce adverse factors, building a humanized management platform, establishing pre-cognitive male nurses' separation management mechanism, and understanding the turnover intention of male nurses in time, were studied to retain male nurses.

Objective:To explore the nursing problems in ICU patients with enteral nutrition-related diarrhea and to constantly standardize the nursing practice of ICU nurses in the prevention and management of enteral nutrition-related diarrhea.Methods:Using convenience sampling method, 367 ICU patients who received enteral nutrition treatment in the Department of critical care medicine of the Tenth People's Hospital Affiliated to Tongji University from October 2019 to June 2020 were selected as the research objects. According to the time, they were divided into three groups: 129 cases before nursing process practice (October to December 2019) as the control group, 117 cases in the first round of action research (January to March 2020) as the action group 1, 121 cases in the second round of action research (April to June 2020) as the action group 2. A group interview method was used to identify problems in nursing of enteral nutrition-related diarrhea. According to the spiral cycle of "plan-action-observation-reflection", the nursing procedure for prevention and management of enteral nutrition-related diarrhea in ICU was formulated and improved. The incidence, duration, and severity scores of diarrhea in the three groups were compared, and interview the nurse's nursing experience.Results:The incidence of diarrhea in action group 1 was lower than that of control group, duration was less than that of control group, and severity score was lower than that of control group, and the differences were statistically significant ( P<0.05) . The incidence of diarrhea in action group 2 was lower than that of action group 1, duration was less than that of action group 1, and severity score was lower than that of action 1 group, and the differences were statistically significant ( P<0.05) . The topics extracted from the group interviews with nurses included "emergent scientific interest" "the joy of solving clinical problems" "benefit from clinical work". Conclusions:The ICU nursing process of prevention and management of enteral nutrition-related diarrhea based on action research can significantly reduce the incidence, duration and severity of diarrhea, improve the quality of diarrhea nursing, enhance nurses' sense of career benefit and stimulate nurses' interest in scientific research.

Objective:To establish a scientifically standardized nursing quality evaluation index system that conformed to the characteristics of enteral nutrition in critically ill patients, with the aim of providing reference for evaluating the nursing quality of enteral nutrition in critically ill patients.Methods:Using the three-dimensional quality evaluation model of "structure-process-outcome" as the theoretical framework, the content of each level of the evaluation index system was preliminarily formulated by literature analysis. From May to July 2022, the Delphi expert consultation method was used to conduct two rounds of consultation with 21 experts to determine the index system.Results:In the two rounds of consultation, the effective response rates of the questionnaire were 85.71% (18/21) and 100.00% (18/18) , respectively. The expert authority coefficients were 0.867 and 0.878, respectively. The expert Kendall's W of the overall index were respectively 0.092 and 0.187 ( P<0.01) . The final nursing quality evaluation index system of enteral nutrition in critically ill patients included 3 first level indicators, 9 second level indicators, and 60 third level indicators. Conclusions:The constructed nursing quality evaluation index system of enteral nutrition in critically ill patients has put forward clear requirements and quality standards for enteral nutrition nursing for critically ill patients, which has good scientific and reliable characteristics and can provide reference for the nursing quality evaluation of enteral nutrition in critically ill patients.

Objective To understand influence factors of the demission of extra-organizational nurses in Shanghai and measures taken by nursing managers for their demission.Methods In-depth qualitative interviews were carried out in 6 included hospital human resource directors of nursing department in Shanghai from August to November 2016 with the method of purposive sampling. Information was collected, transcribed and the themes were extracted.Results Nursing managers in Shanghai considered that the main 3 aspects of influence factors of the demission of extra-organizational nurses should be the lack of social support system, the increase of nursing professional pressure and the limitation of personal career development. The 6 themes of countermeasures taken by managers included: fading the concept of extra-organizational nurses and organizational nurses; reducing the influence of majeure factors; improving the social status of nurses; strengthening the nurse training; strengthening the humanistic care; using the incentive mechanism.Conclusions Nursing managers in Shanghai think that the demission of extra-organizational nurses is influenced by various factors. Nursing managers can adopt positive and effective measures to reduce the nurses' demission.