Objective To investigate the effects of different cleaning methods combined with hypothermia sterilization for rigid endoscopic instruments.Methods A total of 300 thoracoscopes, 60 mediastinoscopes and 200 titanic clips were selected in the supply room of Nanjing Chest Hospital from March to September 2015 and randomly divided into two groups. The control group underwent traditional hand-washing combined with hypothermia sterilization, while the observation group underwent enzymatic ultrasonic cleaning combined with hypothermia sterilization. The cleaning effects of two groups were compared using three different methods: visual method, protein clean & testing stick, and pharynx swab culture.Results All the endoscopic instruments in the observation group has a higher qualified rate than those in the control group, with statistically significant differences between two groups (P<0.05). Both groups have a qualified rate of 100%.Conclusions The enzymatic ultrasonic cleaning combined with ethylene oxide or hydrogen peroxide hypothermia sterilization for endoscopic instruments guarantes the quality of cleaning and sterilization and is worthy to be promoted.

Objective To explore the high-risk factors of tracheobronchial aspiration of gastric contents of patients in Neurosurgical ICU, so as to provide basis for aspiration prevention as well as related complications.Methods The prospective cohort study was conducted during the patients with mechanical ventilation who were continuously enrolled. The general information and condition of 74 patients from two tertiary hospitals were recorded and their tracheal secretions were collected. The content of pepsin A in airway secretions was determined whether there is an aspiration.Results The incidence rate of aspiration in 74 patients was 39.2%. The chi-square test results showed that the angle of backrest elevation, the rate of enteral nutrition pump, diameter of nasogastric feeding tube, gastric residual volume, airbag pressure, Glasgow score and the use of sedatives were all related to the occurrence of aspiration (χ2/F =30.771, 16.845, 11.471, 9.212, 6.582, 15.664, 11.722, 18.312;P<0.05). Logistic regression analysis indicated five risk factors related to aspiration, including bed elevation angle, rate of enteral nutrition pump speed, airbag pressure, whether the use of sedatives and gastric residual volume. AUC of risk score calculation is 0.994,RR=1.979 (1.351,2.900). The risk of patients whose AUC score≥10 was double of patients whose AUC score<10.Conclusions To reduce the incidence of aspiration of gastric contents, for patients without contraindications, angle of backrest greater than 30 degrees, maintaining cuff pressure between 20 and 30 cmH2O, nasogastric feeding rate< 25 ml/hour, small bowel feeding rate<45 ml/hour, and GRVs ≥50 ml, gastric feedings and enteral nutrition are recommended; pay attention to patients usingsedative drugs, can also reduce the aspiration rate of gastric contents.

Objective To investigate experiences of nursing students in the treatment of wounded persons in typhoon disaster.Methods A total of 11 nursing students who took part in the treatment of wounded persons in typhoon disaster were semi-structured interviewed. Colaizzi analysis method was used to collect, organize and analyze data so as to conclude the theme.Results Through the interview and conclusion,three themes of mental reaction were identified:emotional experiences in disaster relief;work experiences in disaster relief;self-demand.Conclusions Nursing students are lack of knowledge of disaster relief. It is urgent and significant to carry out disaster nursing education. Clinical teacher should play a model role and guide nursing students to develop advantages in disaster relief,enhance the psychological counseling of nursing students and establish the nursing talent team in disaster relief.

Objective To analyze the current situation of the development of brain tumor care and provide the guidance and basis for the future research.Methods Web of Science database screening was performed using subjects "brain neoplasms nursing" or "brain neoplasms nursing care" or "brain tumor nursing" or "brain tumor nursing care" to search for literatures up to September 2016. Searching results were refined, saved and import into CiteSpace software. Cluster analysis was performed to implement scientific visualization analysis of literatures.Results Visualization analysis of 172 study objects showed that: the studies were more common in Europe and America than in Asia, mainly in the United States; the study of intracranial tumor care tended to be mature and reached the peak in 2013; literatures were from 21 types of journals, mainly from Oncology Nursing Forum journal; there were 4 research hotpots including the cognitive function, emotional state, quality of life, social support of patients with brain tumor.Conclusions The incidence of brain tumors is increasing with the improving in living standards. Following the interest in the hotspot and development of brain tumor nursing care is more conducive to improve the nursing care.

Objective To explore the efficacy and safety of a new-type anti-lippage infusion set. Methods Totally 400 inpatients receiving infusion between January and December 2015 were selected and equally and randomly divided into an observation group and a control group. Patients in the observation received intravenous infusion with an independently-developed and new-type anti-slippage infusion set, while patients in the control group received infusion with common disposable infusion sets. Then their accidental slippage rate and incidence of infusion reaction were observed.Results As for the control group, totally 29 patients saw accidental slippage and 9 patients showed adverse reactions to infusion,while no patients in the observation group saw accidental slippage and only 1 patients had adverse infusion reactions(χ2=31.27, 6.56;P<0.05).Conclusions The new-type anti-slippage infusion set reduces the accidental slippage rate, and it is safe and worthy of clinical application and expansion.

Objective To discuss the establishment and application effects of secondary triage management system based on JCI standard in outpatient clinic of maternal and child health care hospital. Methods In July 2015,secondary triage mode was implemented and secondary triage management team was established in our hospital under the JCI standard basis. Nursing staff were trained. The secondary triage management system in outpatient clinic,job and responsibilities of nurses and work flow of secondary triage mode were developed. Satisfaction of patients and doctors in outpatient clinic and waiting time of patients before (January 2014 to June 2015) and after (July 2015 to October 2016) the implementation of secondary triage mode were compared.Results After the implementation of secondary triage mode,the satisfaction of patients increased from (85.76±15.24) to (96.38±12.91),while satisfaction of patients increased from 88.80% to 97.20%. The waiting time of patients decreased from (59.64±12.38) min to (40.55±10.96) min. The differences were statistically significant (t/χ2=15.634,13.550,9.915;P<0.001).Conclusions The secondary triage management model can reduce the waiting time of patients and improve their satisfaction.

Objective To investigate the current situation of career decision-making self-efficacy of higher vocational nursing students during practice,and analyze the relationship between professional commitment,emotional intelligence and career decision-making self-efficacy to provide reference for the career development,career guidance and career education.Methods Nursing students from 6 classes (less than 3 months until the end of clinical practice) in Changsha Health Vocational College were randomly selected from April to May 2016. The questionnaires were distributed and taken back on the spot. The questionnaires consisted of general information questionnaire,career decision-making self-efficacy scale,professional commitment scale and emotional intelligence scale. The Chinese version of SPSS 22.0 was used for data statistics and analysis. Results The average score of career decision-making self-efficacy was (3.16±0.43). In self-assessment, information-acquisition,planning and problem-solving aspects,the differences of students between 3-year system (starting point from high school) and 5-year system (starting point from junior school) were statistically significant (t=2.72,2.70,2.88,2.54;P<0.05). Statistically significant difference was observed between the scores of the only-child students and the non-only-child students (t=2.53,3.09,3.71,2.43;P<0.05). Professional commitment,most dimensions of emotional intelligence were positively correlated with career decision-making self-efficacy (r=0.568,0.361,0.509,0.435,0.390,0.360,0.373,0.176,0.348;P<0.05). Emotive commitment,ideal commitment,normative commitment and emotional development were positive predictors of career decision-making self-efficacy scores which explained 38.1% of the total variance (t=3.492, 2.633,2.116,1.862;P<0.10).Conclusions The level of career decision-making self-efficacy of higher vocational nursing during practice was not high. Professional commitment and emotional intelligence affect the career decision-making self-efficacy. Higher vocational college should improve levels of professional commitment and emotional intelligence of the students,strengthen the cultivation of professional role and promote successful employment of nursing students.

Objective To investigate the academic delay of gratification and its influencing factors among undergraduate nursing students.Methods A total of 281 students in 2 colleges of Harbin were included using convenience sampling method from April to May in 2016 and surveyed using questionnaire. Demographic questionnaire, college students′ hope questionnaire and academic delay of gratification scale were used for the questionnaire.Results The mean score of the hope of undergraduate nursing students was (2.92±0.43). The score of family hope was the highest, while the score of love hope was the lowest in the five subscales of hope. The mean score of undergraduate nursing students′ academic delay of gratification was (2.65±0.54). The influencing factors of academic delay of gratification in undergraduate nursing students included academic hope,leisure hope, gender and grade.Conclusions The academic delay of gratification of undergraduate nursing students is influenced by various factors. Higher nursing institutions should establish effective measures and improve management system to increase the academic delay of gratification of undergraduate nursing students and strengthen their physical and mental health.

Objective To evaluate the effects of the training program based on the competency of new nurses in neurology department.Methods Competency concept was used to analyze the needs,insure the objective,establish the training plan,and organize training for new nurses in neurology department from August 2015 to March 2016. Training program with the combination of group psychological counselling,scenario simulation training and assessment were performed. Observation indexes were analyzed using the Six-Dimension Scale of Nursing Performance (6-D Scale).Results Group psychological counselling played a crucial role in the elimination of new nurses′ strangeness so as to help them to adapt to clinical competence. Statistically significant differences in new nurses′ ability of planning and evaluation,ability of interpersonal relationship and communication,ability of education and training were observed before and after training based on 6-D scale (P<0.05).Conclusions The training program based on the competency can improve the planning and evaluation ability,interpersonal relationship and communication ability,education and training ability in new nurses,and play a positive role in the growth of new nurses to qualified nurses.

Venous thromboembolism (VTE) is one of the most important leading causes of death in hospitalized patients. It is often asymptomatic, leading to long-term complications and results in death. VTE prophylaxis can reduce the incidence rate of VTE and is an important component in the safety management of hospitalized patients. VTE risk assessment plays an important role in thrombosis prevention. Recently, the Caprini risk assessment model has been validated worldwide. In this study, the research progress of the Caprini risk assessment model were reviewed to provide reference for clinical application of the Caprini risk assessment model.