Objective To apply meticulous management in clinical nursing pathway so as to make it scale and effectively advance .Methods The management of clinical nursing pathway focusing on hierarchical management , process system , training implementation and performance appraisal in meticulous management were carried out through the daily , mid-term, terminal evaluation .The patients with pilot disease and ward nurses who did not receive or received the meticulous management were divided into the control group and the intervention group .The patient satisfaction , the nursing quality and the comprehensive ability of clinical nursing were respectively evaluated by the questionnaire about patient satisfaction , the nursing quality assessment and the clinical skills assessment .Results The average hospital days and costs after the application of meticulous management were respectively (8.62 ±0.41) d, (12 920.54 ±415.19)yuan, and were lower than (10.46 ± 0.54) d, (14 061.74 ±423.17) yuan before the application of meticulous management , and the differences were statistically significant (t =37.41, 24.35, respectively;P <0.01).The patients satisfaction after the application of meticulous management was increased from (86.18 ±3.41) % to (95.27 ±3.62) %, and the score of the comprehensive ability of clinical nursing was increased from (73.21 ±4.21) to (81.24 ±4.37), and the differences were statistically significant (t=-23.12, -13.23, respectively;P<0.01).Conclusions The application of meticulous management in the process of clinical nursing pathway is practical .

Objective To explore the effect of static air cushion at different intervals on preventing from pressure ulcers in bedridden patient .Methods One hundred patients in the department of orthopedic were chosen through the convenience sampling and self-controlled.The patients were supine , and the computer pressure sensor ( Xsensor manometry carpet ) was tiled under the body of patients .The average pressure peaks in the two lateral heel and sacrococcygeal were respectively measured after 2 h of lying ordinary mattress and 2, 3, 4 h of lying static air cushion , and the integrity of skin and the incidence of pressure ulcer were monitored during patients’ stay in bed.Results After 2 h of lying ordinary mattress , the cases of I stage pressure ulcer were 3 cases including 1 case of left heel and 2 cases of sacrococcygeal , and the incidence rate of pressure ulcer was 3%.After 2, 3, 4 h of lying static air cushion, the incidence of pressure ulcer in patients was not found , and the integrity rate of skin was 100%.After 2 h of lying ordinary mattress and static air cushion , the average pressure peaks were respectively (185.03 ±11.34), (69.13 ±9.64) mmHg in the left heel, and were (176.03 ±18.64), (76.40 ±11.52) mmHg in the right heel, and were (253.03 ±28.64), (100.23 ± 18.36)mmHg in the sacrococcygeal, and the differences were statistically significant (t =7.126,6.287, 4.235, respectively;P<0.05).No differences were found in the change of average pressure peaks in the two lateral heel and sacrococcygeal after 2, 3, 4 h of lying static air cushion ( F =5.863, 3.128, 4.852, respectively;P>0.05).Conclusions Static air mattress can effectively reduce vertical pressure on the surface of pressed parts in the bedridden patients , and the interval time of turning over can be prolonged to 4 h every time, and which can reduce the patients ’ pain caused by frequently turning over but also reduce the nurses ’ labor intensity .

Objective To explore the clinical application value of a small sealed bottle in the pseudoaneurysm after coronary arteriography .Methods Sixty-four with pseudoaneurysm after coronary arteriography selected in second people ’ s hospital of Wuxi city were randomly divided into observation group and control group , 32 cases in each group .Control group received elastic bandage pressing arterial puncture part , while observation group received small sealed bottle pressing .Hamilton anxiety scale ( HAMA) was applied to evaluate the anxiety symptoms of patients in two groups , and the healed time , hospital stays and postoperative satisfactory degrees were also compared .Results The healed time [(2.7 ±0.6) d], hospital stays [(4.8 ±1.6)d] and anxiety symptom scores (1.9 ±0.8) in observation group were significantly shorter/lower than in control group [(5.4 ±1.3) d, (7.2 ±2.1) d, (2.7 ±1.1)], and all the differences had statistical significance (t=10.668,5.142,3.327,respectively;P<0.01).Besides, the satisfactory degree of patients in observation group (93.6%) was evidently higher than that in control group (65.6%), and statistically significance difference was presented (χ2 =7.819,P<0.01).Conclusions The local part bound up by elastic bandage in combination with a small sealed bottle pressed the arterial puncture part can obviously shorten the healed time and hospital stays of patients with pseudoaneurysm after coronary arteriography , promote the surgical limb recovery , alleviate anxiety symptoms and improve the patients ’ satisfactory degree , so it deserves to be popularized and promoted in clinic .

Objective To investigate implementing approach and clinical effect of 4-dimensional innovative model basing on JCI standards on health education to elderly patients with CHD.Methods Following JCI standards, a 4-dimensional model was innovated, regarding 4 aspects of health education for elderly patients with CHD:concept, platform, transmission system and technological application. Totals of 120 elderly patients with CHD were divided randomly into observation group and control group. For the patients in the observation group, health education was conducted according to the 4-dimentional innovative model, while in the control group, routine health education approach for CHD was used, which was to hand out health pamphlets explaining knowledge concerning diet, drug, exercise, follow-up visit, etc. After 5 days of intervention, CHD organism functional status and quality of life of the CHD patients in the two groups were evaluated and compared. Indexes, such as self-management skills, were compared 6 months after discharge. Results In SAQ scoring, there were significant differences between observation group and control group regarding limitation degree of motion, attacking condition of angina or stable condition of angina, scores of satisfaction on treatment and awareness of the disease ( P<0. 05 ) . Conclusions Conducting health education to elderly patients with CHD with the 4-dimensional innovative model basing on JCI standards plays a significant role in promoting guarantee of medical safety, prevention of harmful cardiac incidents, and enhancement of treatment compliance, patients′ self-management abilities and patients′satisfaction.

Objective To understand the current situation of nurses' professional happiness and preliminary evaluate the effect of intervention measures in order to provide the basis for formulating the corresponding countermeasures. Methods In March 2016, 203 nurses were selected as the research subject by the stratified random sampling method. After consulting the relevant data, a questionnaire was made to investigate the well-being and satisfaction of nurses. After 1-month investigation of current situation, a comprehensive intervention was conducted, the time was 7 months. In December 2016, second investigations were conducted on the same staff to evaluate the effect of intervention measures. Results The subjective feeling of happiness was relatively low of 203 subjects and was 14.8%, proportion with feeling unhappy was 36.5%, and personal income, working environment, personal value, health were the main factor affecting the happiness. After the implementation of comprehensive intervention, happiness and satisfaction scores of the subjects were increased, the differences were statistically significant before and after implementation (P<0.05). Conclusions The subjective feeling of happiness of nurses is low. From the point of view of humanistic care, career planning and fair motivation, the implementation of the plan of promoting occupational well-being based on the perspective of hospital culture is of great significance for stabilizing the nursing team and arousing the enthusiasm of nurses.

Objective To investigate the effects of "one to one" tutorial system of two-way selection model in the standardized training of new nurses.Methods Using purposive sampling, a total of 25 new nurses recruited in July 2014 were selected as the control group,and they received traditional teaching mode. Another 25 new nurses recruited in July 2015 were selected as the observation group,and they received "one to one" tutorial system of two-way selection model. The theoretical and operating scores,general self-efficacy and career self-efficacy of nurses were compared between two groups after one year's training.Results The sores of basic theory,basic operation,professional theory and bedside practice in the observation group were (89.99±5.76), (90.08±2.56),(88.39±6.71) and (92.74±4.30),which were significantly higher than (85.61±6.27),(87.99±3.27),(84.30±5.74) and (89.22±3.55) in the control group (t=2.105,2.296,2.591,2.543;P<0.05). There was no significant difference between two groups in the scores of general self-efficacy,educational requirements and job duties before the training (P>0.05). After one year's training,the scores of general self-efficacy,educational requirements and job duties in the observation group were (31.48±3.12),(15.24±2.16) and (15.64±2.48),which were significantly higher than (26.96±3.54),(11.66±2.54) and (12.40±2.50) in the control group (t=3.901,4.177 and 4.825;P<0.01).Conclusions "One to one" tutorial system of two-way selection model in the standardized training of new nurses could make new nurses change from students to qualified nurses faster and it is worth to be expanded.

Objective:To explore the effect of core stability training on rehabilitation of patients after lumbar fusion.Methods:From June 2018 to December 2019, 90 patients with lumbar fusion admitted to Wuxi Second Hospital Affiliated to Nanjing Medical University were selected by convenience sampling. The patients were divided into control group and training group according to the method of random number table, with 45 cases in each group. The control group received routine postoperative rehabilitation nursing, while the training group carried out postoperative core stability training nursing. The rehabilitation effects of the two groups were observed.Results:The scores of Numerical Rating Scale (NRS) in the training group were lower than those in the control group at 2, 4, 12 and 24 weeks postoperatively, and the difference were statistical ( P<0.05) . The scores of Oswestry Disability Index (ODI) in the training group 12 and 24 weeks after operation were lower than those in the control group, with statistically significant differences ( P<0.05) . Conclusions:The core stability training nursing is helpful to improve the functional recovery after lumbar fusion, reduce the degree of postoperative pain, and then increase the rehabilitation effect of patients.