Epidemic influenza (flu) is a disease threatening the life of people for a long history.A precise forecast for the flu outbreak can warn and help health care providers to take measures to reduce the influences and harms in advance.At present,with the development of information technology,there have accumulated tremendous data of flu trends and climate information.With a history of 90 years researches about the forecast of flu trends,researchers have put forward different types of forecasting methods,and each of them has merits and demerits.Among these methods,those ones considering the key climate factors have higher precisions.Considering various methods at present,the prediction accuracy can be improved mainly from two aspects:on one hand,the forecast accuracy can be improved by effectively integrate the advantages of different models ; On the other hand,the prediction must take into account of the specific climate of an area,pathogens and the mode of transmission characteristics in order to determine the most relevant climate factors or other highly related factors with which to design a more reasonable and accurate prediction method.

Objective:To explore the combined application effect of failure mode and effect analysis (FMEA) and root cause analysis (RCA) in IV infusion risk management of pediatric outpatient so as to enhance the quality of care and ensure the safety of outpatients.Methods: For this exploration, a special analysis team was established and the flowchart was drawn up, and the potential failure modes were listed by using FMEA. And the RCA was used to analyze and evaluate the key mode in these potential failure modes so as to find the root cause might affect the safety of IV infusion, and then the improved measures were implemented and the effects of new measurement were evaluated. Results:After implemented the improved measures, the risk of top 4 risk priority number (RPN) in intravenous infusion flow decreased obviously. For the transfusion management, patients' satisfaction increased from 78.09% to 95.03% (P<0.05), and nurses' satisfaction increased from 83.79% to 97.80%(P<0.05).Conclusion: The combined application of FMEA and RCA in the IV infusion risk management of pediatric outpatient can effectively reduce the occurrence of risk events, reduce nursing complaints and disputes, and enhance the quality of nursing care.

Objective To retrieve and analyze the available evidence on prevention of needlestick injuries among healthcare workers and summarize the best available evidence.Methods We searched the BMJ best practice,Uptodata,Cochrane Library(2014),Joanna Briggs Institute Library,Registered Nurses' Association of Ontario,Scottish Intercollegiate Guidelines Network,National Guideline Clearinghouse,and complementally searched the PubMed,EM-base,CNKI and Centers for Disease Control to collect literatures including guideline,evidence summary,best practice information sheet,recommended practice and systematic review.Results Nine references were selected including a clinical decision support system,3 evidence summaries,2 recommended practices and 3 systematic review.Finally,7 items of best evidence were summarized,including:wearing double gloves,never recapping needles,using blunt-tip suture,using a neutral zone for passing sharp device,adopting the safety features of sharps,using sharp disposal containers,and continuous education for needlestick injuries.Conclusion Healthcare workers should regulate their behaviors of using sharp instruments during clinical practice and guarantee personal safety by consulting high level evidence.

Objective To investigate nursing interns’knowledge and attitude towards needle stick injury before clinical practice.Methods In 20-23 June,2015,nursing interns who were about to start clinical practice in a hospi-tal were investigated,nursing interns’knowledge and attitude towards needle stick injury were surveyed through questionnaire.Results A total of 350 questionnaires were distributed,324 (92.57%)responded questionnaires were available.40(12.35%)questionnaires were responded by male interns,and 284(87.65%)were by female in-terns;34(10.49%)interns had bachelor degree;the mean age of interns were (20.83 + 1 .24)years old.The correct answer rates about questions related to injury occurring during needle recapping and wearing gloves were low (about 60%).About 70% of the interns gave the correct answers to questions about hepatitis B infection due to needle stick injury following hepatitis B vaccination,as well as medication after injury.Score for individual question about attitude towards needle stick injury was ≤3,the major related problems were susceptibility of blood borne diseases and recapping needles.Conclusion Needle stick injury-related knowledge and attitude among nursing interns is inadequate,including recapping needles,timely report,susceptible to infectious diseases,and so on.It is necessary for schools and teaching hospitals to strengthen the education about occupational protection among nursing interns, so as to improve the attitude and ability of professional protection.

Objective To explore the clinical efficacy of enteral nutrition combined with traditional Chinese medicine (TCM) acupuncture and moxibustion for treatment of craniocerebral trauma complicated by gastric paralysis.Methods A prospective study was conducted.One hundred and sixty-seven patients with craniocerebral trauma complicated by gastric paralysis admitted to the Department of Neurological Critical Care Medicine in Affiliated Hospital of the Logistics University Chinese People's Armed Police Force from January 2013 to October 2015 were divided into single group (83 cases) and combined group (84 cases) according to the random number table method.The basic treatment program was the same in the two groups.On the basis of gastrointestinal decompression,a nasojejunal tube was indwelled in the digestive canal of the patients in single group,and the nutrient food could be given by dripping slowly and continuously through the tube into the body,while in the combined group,they were additionally treated by acupuncture and moxibustion at auricular point,zusanli and neiguan acupoints,1 time a day,each time 30 minutes.Both groups were treated consecutively for 30 days,and then the clinical efficacies were evaluated.Before and after treatment in both groups,the changes of total serum protein (TP),pre-albumin (PA),hemoglobin (Hb) were observed;the incidences of reflux,vomiting,abdominal distension,diarrhea,pulmonary infection and intestine derived infection were also evaluated.Results After treatment the levels of TP,PA,Hb were significantly higher in combined group than those in the single group [TP (g/L):36.97 ± 2.17 vs.33.14± 2.13,PA (mg/L):215.19 ± 7.91 vs.203.15 ± 6.12,Hb (g/L):126.73 ± 11.17 vs.117.61 ± 11.24,all P ＜ 0.01].The numbers of patients with reflux,vomiting,abdominal distension,diarrhea were significantly lower in combined group than those in the single group,respectively (the number of patients had reflux being 15 cases vs.31 cases,vomiting 13 cases vs.28 cases,abdominal distension 17 cases vs.29 cases,diarrhea 17 cases vs.31 cases) and pulmonary infection (17 cases vs.29 cases),intestine derived infection (4 cases vs.12 cases),all the above comparisons showing statistically (all P ＜0.05).Conclusions Enteral nutrition combined with acupuncture and moxibustion treatment can effectively enhance the patients' nutritional status,reduce gastrointestinal dysfunction and the incidence of complications,thus the prognosis of patients with craniocerebral trauma complicated by gastric paralysis is obviously improved.

BACKGROUND:Studies have shown that posterior orthopedic internal fixation and anterior orthopedic internal fixation al can get good clinical outcomes for treatment of adult idiopathic scoliosis, however, it has not been reported on what kind of methods could achieve a better clinical outcome for treatment of Lenke3 type adult idiopathic scoliosis, have less risk of pedicle screws breakage and more reliable long-term efficacy. OBJECTIVE:To establish the Lenke 3 type adult idiopathic scoliosis finite element model and thoracic screw guide target 3D model using finite element analysis software, so as to provide scientific basis for biomechanical analysis and scientific pedicle screw implantation. METHODS:The CT scan image from T 1 to sacrum of one 28 years old volunteer with Lenke 3 type adult idiopathic scoliosis was imported into Mimics 16.0 software by Dicom form. Integral idiopathic scoliosis three dimensional model was established by geometry clear technology. Nail guide target of thoracic vertebra was established on vertebral model by design module in Mimics 16.0 software. The point cloud form of three dimensional model was imported into Geomagic Studio 11.0 software. Series of image processing of model were conducted. At last, three dimensional model was imported into ANSYS 14.0 finite element analysis software in order to build finite element model with biological properties. RESULTS AND CONCLUSION:Complete Lenke 3 type adult idiopathic scoliosis three dimensional finite element model was established successful y. It concluded 440 975 tetrahedron units and 580 bar units, total y 441 555 units and 1 077 318 nodes. Total y 12 nail guide target models of thoracic vertebra were established, including 4 682 tetrahedron units and 7 390 nodes. Lenke 3 type adult idiopathic scoliosis three dimensional finite element model and nail guide target of thoracic vertebral model with a realistic appearance were established successful y in this experiment. These results confirm that Lenke 3 type adult idiopathic scoliosis three dimensional finite element model provides scientific basis for further biomechanical experiments. Meanwhile, the construction of nail guide target model of thoracic vertebra provide a new scientific method for thoracic pedicle screw placement.

Objective To explore the effect of scenario simulation training to nurses in improving the rescue ability at ICU. Methods A total of 84 nurses were enrolled and divided into12 groups, who received 6 scenarios training developed by researchers. The score of theoretical knowledge, time of practice completion and 7 operating practices were compared before and after training. Results The theoretical knowledge score of the nursing staff before the exercise was 72.21 ± 3.14, and the score was 91.77 ± 4.55 after the exercise, and the difference before and after the exercise was statistically significant (t=2.77, P<0.05). After practice, nursing staff in cardiopulmonary resuscitation (CPR), intestinal spillover, limb fracture, pelvic fractures, burns, bleeding, glass into the seven skills score 96.23 ±4.80, respectively 96.92±4.12, 96.59±3.97, 93.79±3.45, 97.71±4.18, 95.58±4.16, 91.67±3.31, were higher than drills before 85.43± 4.55, 65.44± 4.21, 74.05± 3.25, 66.35± 2.95, 85.31± 4.05, 81.41± 3.11, 69.59± 3.96.There was a significant difference in 7 operational skills between before and after operation (t=4.010-9.780, P<0.01) . After practice,six scenario completion time was (265.45 ± 41.37), (274.90 ± 43.15), (296.52 ± 42.09), (285.44 ± 47.15), (296.42 ± 43.51), (303.50 ± 36.92) s respectively, than drills before (366.29 ± 41.12), (363.54 ± 32.94), (367.78 ± 33.75), (371.29 ± 40.16), (370.57 ± 34.69), (372.98 ± 35.32) s. There was a significant difference in time of finishing 6 scenarios between before and after operation exercises (t =2.190-6.210, P< 0.05). Conclusions Scenario simulation model training can improve the theoretical knowledge, time of practice completion andpractices ability of ICU nursing.

Objective To discuss the application of informed consent of skin care. Methods The informed consent of skin care was designed by nurses themselves. Informed consent of skin care was applied in the nursing of critically ill patients from October 2013 to August 2014. Comparisons were conducted before and after the use of informed consent of skin care. Results After the application of the informed consent of skin care, there was no complaints while the incidence of complaints was 9. 86% before the application of informed consent of skin care (P<0. 05). Family satisfaction of the skin care was higher than before the application of the informed consent of skin care (98. 4% and 87. 3%) (P <0. 05). Conclusions The application of the informed consent of skin care can improve the quality of skin care in critically ill patients, enhance the relationship between nurse and patient, increase the satisfaction of skin care.

Objective To explore the hemostatic effects of the hypothermal tourniquet on elderly patients after radial arterial blood collection. Methods A total of 200 patients ( over seventy years older) after blood collection were divided into experimental group and control group by random number table. The hypothermal tourniquets was introduced for hemostasis in the experimental group while the traditional pressure hemostasis was used in the control group. We compared the pain level and skin status at the pricking point. Results The pain score of pricking point in the control group was (5. 6 ± 1. 506) compared with (1. 9 ± 1. 287) in the experimental group (t=6. 40,P<0. 01). The incidences of bleeding, ecchymosis, hematoma, numbness of limb at pricking point in the experimental group were 2. 0%, 3. 0%, 2. 0%, 6. 0%, while they were 10. 0%, 12. 0%, 11. 0%, 21. 0% in the control group (χ2 =5. 67, 5. 84, 6. 66, 9. 63;P<0. 05). Conclusions The application of hypothermal tourniquet is a effective method to stop bleeding among elderly after radial arterial blood collection.

Objective:To evaluate the competence of head nurses by using the in-basket test for establishing a hierarchical training system for these nurses.Methods:A set of in-basket test was independently designed to evaluate the head nurses of a tertiary hospital in September 2021.Fourteen competency indicators, including positive initiative, coordination and communication ability, and leadership, problem solving ability, motivation, empowerment, attention to quality and order, etc, were selected to analyze the answers of the in-basket test and score their competency level. The measures were described by Mean±SD and M(IQR), and the counts were described by rates and percentages. The rank sum test and multiple linear regression were used to analyze the influencing factors of competency scoring of head nurses. Results:A total of 133 head nurses were tested, with a total competency scoring of 30.0(5.5). The highest indicators were talent cultivation 3.0(2.0), positive initiative 3.0(1.0), coordination and communication ability 3.0(1.0), while those with lower scores were empowerment 1.0(1.0) and motivation 1.5(1.5). The rank sum test analysis showed that age, position, job position character and working seniority were the influencing factors of competency score( P<0.05). The multiple linear regression analysis showed that, working seniorities of 16-20 years( β=0.583, P=0.013), 21-25 years( β=0.732, P=0.008), 26-30 years( β=0.632, P=0.026) were the influencing factors of competency score of head nurses. Conclusions:The in-basket test is practical to evaluate the competence of head nurses as a basis for their targeted training in the future.