Objective To evaluate the effects of Phentolamine combined with Lincomycin Hydrochloride and Lidocaine Hydrochloride Gel for phlebitis caused by amiodarone extravasation in an animal study.Methods A total of 15 adult rabbits were selected in March 2017. We built a model according to amiodarone damage. All of the rabbits were numbered by weight from light to heavy and divided into five groups with the random number table including group A (model group), group B (group with 50％ magnesium sulfate for external application), group C (with Phentolamine for external application), group D (with Lincomycin Hydrochloride and Lidocaine Hydrochloride Gel for external application) and group E (Phentolamine combined with Lincomycin Hydrochloride and Lidocaine Hydrochloride Gel for external application). We compared the differences in naked eye observation, pathological observation and immunohistochemistry among five groups and compared the differences of group A with other four groups.Results There were no significant differences in effects of symptom observation among five groups on the first day after different treatments for amiodarone extravasation (P>0.05). The differences in treatment effects were significant among five groups on the second and third day after treatments (P<0.01). There were significant differences between group D and group A, group E and group A on the second and third day after treatments for extravasation (P<0.05). The differences in ear vein and surrounding tissues pathological injury of rabbits were significant among five groups on the third day after different treatments for amiodarone extravasation (P<0.05). There were significant differences in average positive rates of vascular endothelial growth factor (VEGF) among five groups (P<0.001), the average positive rate of VEGF in group A was higher than that in other four groups (P<0.05); the average positive rate of VEGF in group E was lower than that in other four groups with significant differences (P<0.05); there was no significant differences among group B, group C and group D (P>0.05).Conclusions The Phentolamine combined with Lincomycin Hydrochloride and Lidocaine Hydrochloride Gel for phlebitis caused by amiodarone extravasation has obvious effects in an animal study.

Objective:To evaluate the quality of guidelines and expert consensus on the prevention of urinary retention after vaginal delivery, so as to provide a reference for clinical prevention and management.Methods:We searched the website of Chinese and English guidelines, electronic literature database and professional society website by computer. The articles were evaluated by three researchers using the Appraisal of Guidelines for Research and EvaluationⅡ (AGREE Ⅱ) and the quality evaluation criteria for expert consensus of the Australian Joanna Briggs Institute Evidence-Based Health Care Center, and the recommendations of each guideline and expert consensus were summarized and analyzed.Results:A total of six guidelines and one expert consensus were included. The recommendation strength of four guidelines was A, and two guidelines were B, and the overall quality of the guidelines was relatively high. One expert consensus evaluation result was "included". Recommendations related to the prevention of urinary retention after vaginal delivery involved a total of 23 comments of risk screening and preventive measures.Conclusions:The quality of the included guidelines and expert consensus is generally high, and their recommendations can provide a reference for the prevention and management of urinary retention after vaginal delivery.

Objective To construct the content framework of pain management plan in perianal abscess patients after surgery so as to provide a basis for scientific pain control. Methods From July 2018 to May 2019, the first draft was developed based on the theory of Manchester pain management mode and cross-cultural nursing theory, evidence-based medicine extraction and needs of postoperative perianal abscess patients on pain management condensed by the qualitative interview. Totals of 15 medical and nursing experts engaging in pain management for a long time were selected in Shanghai by purposive sampling to revise the first draft with the Delphi method so as to construct the content framework of pain management plan in perianal abscess patients after surgery. Results Following two rounds of expert consultation, the content framework of pain management plan included 5 first-level indexes, 23 second-level indexes and 67 third-level indexes. The expert authority coefficient was 0.90. There was a statistical difference in the expert coordination coefficient (P<0.01). Conclusions Construction of the content framework of pain management plan in perianal abscess patients after surgery is scientific and credible. The content combines with the evidence-based medicine as well as patient needs and is practical which plays a guidance role in postoperative pain management for perianal abscess patients.

Objective:To retrieve, screen, evaluate and synthesize evidence related to the management of pregnant women during pregnancy after cervical cerclage to provide a basis for clinical practice.Methods:According to the "6S" evidence resource pyramid model, the system searched of all evidence on the management of pregnant women after cervical cerclage in databases suchas UpTo Date, BMJ Best Clinical Practice, International Guidelines Network, American Guidelines Network, World Health Organization website, Yimaitong, Metz Medical website, Clinical Guidelines website, American College of Obstetricians and Gynaecologists, Royal College of Obstetricians and Gynaecologists of the United Kingdom, Canadian College of Obstetricians and Gynaecologists, French College of Obstetricians and Gynaecologists, European Association of Perinatal Medicine, Cochrane Library, the Joanna Briggs Institute (JBI), the Centre for Evidence-Based Health Care Database, PubMed, Embase, Scopus, Web of Science, CNKI, Wanfang Database, VIP Database, and China Biomedical Literature Database, including best dicision practices, guidelines, expert consensus, evidence summary, systematic reviews, Meta-analysis. The search time limit was the establishment of the database to March 1, 2023, and the evidence was extracted and summarized according to the theme after the two researchers independently evaluate the quality of the literature.Results:A total of 8 studies were selected, including 2 expert consensuses, 2 systematic reviews and 4 guidelines. Through literature reading, evidence extraction and classification, 23 pieces of best evidence were summarized from seven aspects: systematic management, activity management, medication management, health behavior management, pregnancy supervision, supervision of the timing of cerclage removal and supervision of psychological state.Conclusions:The best evidence quality and autuority of pregnancy management for pregnamt women after cervical cerclage surgery summarized in the study are high. It was recommended to strengthen the management of pregnant women during pregnancy after cervical cerclage, dynamically and continuously assess the pregnancy status of pregnant women, and prudently selected evidence to improve the prenatal examination process, ensure the safety of mothers and babies, and reduce the occurrence of complications. Overall, effective management of pregnant women during pregnancy after cervical cerclage required a combination of many factors to ensure the health and safety of the mother and baby.

Objective:To investigate the status quo of knowledge, attitude and practice of enterostomal therapists (ET) in chronic wound pain management and analyze its influencing factors, so as to provide references and suggestions for continuous improvement of wound pain management.Methods:The convenient sampling method was used to investigate 260 ET objects. The survey tools were a self-designed General Information Questionnaire and questionnaires on knowledge, attitude and practice of ET on chronic wound pain.Results:A total of 260 questionnaires were distributed and 238 were valid. The score of ET on chronic wound pain knowledge questionnaire was (5.90±1.49) , the score of ET on chronic wound pain attitude questionnaire was (25.74±3.57) and the score of ET on chronic wound pain management practice questionnaire was (53.28±12.52) . The results of multiple linear regression showed that professional title, working years in wound care and working experience in relevant departments of oncology were the influencing factors of knowledge, attitude and practice of ET in chronic wound pain management ( P<0.05) . Conclusions:ET lacks knowledge of chronic wound pain and has acceptable attitudes, and his practical behaviors need to be strengthened urgently.Hospital administrators vigorously develop full-time ET and implement multidisciplinary collaboration to manage wound pain. When selecting ET training personnel, it is recommended that nurses at or above the intermediate level be the target of training. For ET, it is necessary to continuously improve professional titles and re-learn, and continuously accumulate experience in practice. For ET schools, a wound pain training knowledge system based on job competence should be established, and corresponding training should be carried out for wound specialist nurses.

Objective:To construct the "Internet + Nursing Service" quality evaluation index based on the three-dimensional quality structure model, so as to provide an objective basis for the standardized and effective development of the "Internet + Nursing Service" quality evaluation.Methods:From January to October 2020, with the three-dimensional quality structure model as the framework, the "Internet + Nursing Service" quality evaluation index item pool and the initial questionnaire were preliminarily constructed by combining with literature retrieval, semi-structured interviews and group discussions. Purpose sampling was used to select 31 clinical nursing, nursing management, human resources, public health management and information technology experts who were engaged in "Internet + Nursing Service" or home care. The Delphi method was used to revise the first draft of the plan to construct the "Internet + Nursing Service" quality evaluation index, and to determine the weight of the index system combined with the analytic hierarchy process.Results:In the two rounds of expert consultation, the authority coefficients were 0.792 and 0.828 respectively, and the Kendall coordination coefficients were 0.076 and 0.075 for the second-level indicators, and 0.138 and 0.150 for the third-level indicators, and the difference was statistically significant ( P<0.05) . Finally, the construction of "Internet + Nursing Service" quality evaluation indicators includes 3 first-level indicators, 13 second-level indicators, and 42 third-level indicators. Conclusions:The "Internet + Nursing Service" quality evaluation index constructed based on the three-dimensional quality structure model is scientific and reliable, and can provide a basis for scientific and effective evaluation of the "Internet + Nursing Service" quality and sustainable improvement.

Objective:To explore the changes of shoulder joint function in patients with clavicle fractures after open reduction and internal fixation at different periods, and analyze its influencing factors.Methods:From January 2019 to June 2020, convenience sampling was used to select 120 clavicle fracture patients with open reduction and internal fixation in Shanghai East Hospital. Patients were investigated using the General Information Questionnaire and the Constant-Murley Score for shoulder joint function at one week, one month, and three months after the operation.Results:The total scores of shoulder joint function of patients at one week, one month and three months after open reduction and internal fixation of clavicle fractures were (42.91±7.38) , (73.13±3.96) and (98.04±3.89) , respectively. Repeated analysis of variance showed that patients with clavicle fractures after open reduction and internal fixation had statistically significant differences in pain, activities of daily living, joint range of motion, muscle strength, and total score of shoulder joint function in different periods ( P<0.01) . One week after the operation, there were statistically significant differences in shoulder joint function of patients with clavicle fractures after open reduction and internal fixation at different ages, with or without caregivers, and functional exercise ( P<0.05) . One month after the operation, there was a statistically significant difference in shoulder joint function in functional exercise ( P<0.05) . Three months after the operation, there was no significant difference in the scores of shoulder joint function among patients with different characteristics ( P>0.05) . The results of multivariate analysis showed, age, caregivers and functional exercise were the influencing factors of shoulder joint function one week after open reduction and internal fixation ( P<0.05) . Conclusions:There are different characteristics of shoulder joint function in different periods after open reduction and internal fixation of clavicle fractures. In the acute phase, attention should be paid to the wound pain at the surgical site, and medical and nursing staff and caregivers should provide daily care and psychological counseling to the patient. In the subacute phase, joint exercises should be strengthened and continuous nursing should be carried out to ensure the continuing effectiveness of rehabilitation exercises.

Objective:To retrieve the relevant guidelines and expert consensus on self-management of patients with high-risk foot diabetes, and analyze the content of high-quality guidelines and expert consensus recommendations, so as to provide a reference for the construction of a guidance program for self-management of patients with high-risk foot diabetes.Methods:Computer-retrieved clinical practice guidelines and expert consensus for self-management of patients with high-risk foot for diabetes from databases, guideline networks, and related professional websites. The search period was from January 1, 2012 to June 5, 2022. The quality of the included literature was evaluated and the evidence was extracted and integrated by 2 researchers. Experts were invited to evaluate the summarized evidence.Results:According to the quality of literature, a total of 12 guidelines (10 at level A and 2 at level B) and 3 expert consensus (expert discussion and decision) were included, and 8 themes were defined as regular follow-up, self-assessment, foot and decompression management, exercise management, nutrition management, indicator management, psychological management, and health education, a total of 28 recommendations. Among them, there were 23 A-level recommendations and 5 B-level recommendations.Conclusions:The quality of the guidelines and expert consensus included in this study is high,the recommended level of the summarized evidence is high. This study provides the reference and basis for the clinical staff to construct and guide the clinical practice of self-management of high-risk diabetic foot patients.

This article summarizes the application status of TeamSTEPPS which can improve performance and patients ' safety as team strategies and tools in the disease management of patients with cardiovascular and cerebrovascular diseases, and prospects the application of TeamSTEPPS in clinical nursing in the future, so as to improve team collaboration efficiency of nursing staff, ensure patients ' safety and improve the quality of nursing work.