Objective To investigate the occurrence of alarm of dialysis machine, and analyze the cause of alarm, so as to reduce the frequency of alarm.Methods The quality control circle (QCC) was established in March 2015 and then we managed alarm events of dialysis machine effectively according to the steps of QCC with professional tools and methods. The intangible andtangibleoutcomes before and after activities were compared.Results The frequency of alarm reduced from 0.249 times per hour to 0.120 times per hour after QCC, the alarming frequency of pressure alarm and balance alarming before and after the implementation of intervention were significantly different (χ2= 4.898,7.339;P<0.05).Conclusions The alarming frequency of dialysis machine can be effectively reduced by cluster intervention measures. The team cohesive force and the ability of team members with scientific methods to solve practical problems can be improved by QCC management.

Objective? To explore the effects of direct operation skill observation in nurses' operation training for continuous renal replacement therapy (CRRT). Methods? Totally 44 nurses who needed to receive CRRT operation training in Peking University First University between January and December 2016 were selected by convenient sampling and divided into the control group (n=21) and the observation group (n=23) according to the random number table. Nurses in the control group were trained using conventional methods, while nurses in the observation group were trained by direct operation skill observation on this basis. The operational performance and satisfaction with training methods were compared between the two groups. Results? The machine operation and catheter change scores of the control group were (92.76±3.79) and (92.28±3.45), respectively, while those of the observation group were (96.32±2.41) and (96.40±2.19), respectively (P＜0.05). The satisfaction with training methods scored (41.05±1.53) in the control group and (50.35±2.21) in the observation group (t=16.08,P＜ 0.05). Conclusions? Direct operation skill observation can improve the operation skills of CRRT nurses and enhance their comprehensive competence, which provides a reference for developing formative evaluation methods in clinical nursing training in the future.

White & Black Tablet is a kind of over-the-counter drugs commonly used in the treatment of common cold, excessive use may cause poisoning symptoms, the light symptom can be cleared without treatment, the serious manifestation is the appearance of central nervous system signs and symptoms, and even the most serious one may die of respiratory or/and circulatory failure. Our department recently admitted a patient with acute "White & Black Tablet" poisoning leading to ataxia syndrome, and the diagnosis and treatment experiences of this case were summarized in this report.

Objective:To investigate the current situation of sitting time and health literacy among high school students in China,in order to provide a basis for improving their physical and mental health levels.Methods:A stratified random cluster sampling method was used to investigate the length of sitting time and health literacy of first and second grade high school students from 31 provinces,cities,and au-tonomous regions in China(data did not include that of Hong Kong and Macao Special Administrative Re-gion,and Taiwan Province of China).The Kruskal-Wallis H method,independent sample Mann-Whit-ney U test,and regression model were used to analyze the influencing factors of sitting time and total health literacy score.Results:(1)The total score of health literacy was statistically significant(P＜0.01)in different regions,urban and rural distribution,annual family income,parents'educational background,age,and gender.(2)The length of sitting was statistically significant(P＜0.01)among multiple groups in different regions,family annual income,parental education,and gender.However,there was no statistically significant difference between groups of different ages and urban-rural distribution(P＞0.05).(3)The analysis of multiple linear regression model showed that the total score of health literacy was positively correlated with the family's annual income and the mother's education,and nega-tively correlated with the father's education and the length of sitting.Standardized regression coefficientβcomparison:Father's education(-0.32)＞family annual income(0.15)＞mother's education(0.09)＞average daily sitting time(-0.02),with father's education having the greatest impact,fol-lowed by family annual income.The length of sitting was positively related to the family's annual income and the mother's educational background,and negatively related to the total score of health literacy.Standardized regression coefficientβ comparison:Annual family income(0.14)＞education background of mother(0.13)＞total score of health literacy(-0.02),with the impact of annual family income the largest,followed by education background of mother.Conclusion:China's first and second grade high school students generally spend a long time sitting every day,and the level of health literacy is generally low.The level of health literacy and sitting time are negatively correlated with each other,and are most in-fluenced by the educational background of high school students'parents and their family economic levels.

Objective To carry out quality assessment and content analysis on guidelines on arteriovenous fistula (AVF) dysfunction monitoring in hemodialysis patients so as to provide a reference for building the localized clinical practice plan. MethodsDocuments were retrieved in guideline websites, professional society websites and electronic databases at home and abroad by computer. Quality assessment was carried out with the appraisal of guidelines for research and AGREEⅡ and JBI quality assessment tool on consensuses, and the recommendations of included guidelines were summarized. ResultsTotals of 4 evidence-based guidelines and one consensus were included with three of them in the level A and one in the level B of overall quality evaluation. A total of 12 items in 7 aspects were extracted including policy-making, team building, monitoring technology, training of personnel, continuous quality improvement, risk assessment and health education. Intraclass correlation coefficients of 4 evidence-based guidelines ranged from 0.866 to 0.935. Conclusions The guidelines have high levels of overall quality, but applicability needs to be improved. The recommendations are in general accord with each other, which can provide a basis for building the localized clinical practice plan.

Objective To investigate effect of the integrated care model based on patients′demand in in-charge patients with chronic kidney disease ( CKD) .Methods Established CKD integrated care team , and a questionnaire survey about knowledge and disease management was conducted in hospitalized CKD patients from January to May, 2013, and established the CKD care referral model in hospital .Results A total of 150 cases of hospitalized patients with CKD received a questionnaire .The scores of patients′awareness of CKD was (4.41 ± 1.11), and the knowledge about kidney disease was (3.21 ±0.84), and the degree of concern for knowledge of disease was (2.75 ±1.30), and disease self-care technology mastery was (1.39 ±0.83).88.67% and 60.00%patients considered disease knowledge received from healthcare professionals , but there were still a large number of patients received knowledge from the media , friends, etc.105 patients (70.00%) hoped to get nursing care of outpatient follow up and education .The integrated care referral pattern in hospital was initially established after team discussion which could provide targeted patients pre-referral care and education , coordinated with one by one referral patterns with one transfer form , post-referral care and education .There were 81 nurses joined the post-referral care and gave their suggestions .Conclusions CKD patients need long-term, continuous, complete and individualized health care and education .Establishment of integrated CKD care referral patterns may be an appropriate way to solve this issue .