The day surgery mode and nursing model are diversified, and the importance of high quality day surgery care is becoming more and more important in the daytime operation. This paper analyzed the day surgery nursing model constantly explored by many large hospitals in accordance with their own development requirements, and their certain achievements. Nursing model of day surgery is mainly composed of three aspects including pre-hospital nursing, hospitalization nursing and continuous nursing, each link is very important. Therefore, it is necessary to adopt a variety of management measures to improve the quality of day surgery nursing from many ways, increase the safety of day operation and improve the patient's satisfaction. The scientific nursing model and high quality nursing will inevitably improve the effect of day surgery, which will bring great social effect and economic benefit.

Perioperative pain is a common problem faced by surgical patients. Pain seriously affects patients' mood, sleep, and functional exercise, resulting in delayed recovery and longer hospital stay. Perioperative pain management has received increasing attention as medical standards develop and awareness of pain increases. This article will describe the concept of perioperative pain (definition and criteria of pain, current status and significance of pain management), pain assessment (contents of pain assessment, common pain assessment tools, time and criteria for pain assessment), pain-related nursing, and propose that perioperative pain care can effectively improve the patients' mental state and physiological conditions, which plays an important role in achieving rapid recovery of surgical patients.

Objective: To explore the effect of early enteral nutrition(EEN) and parenteral nutrition(PN) on the postoperative outcomes of patients with gastric cancer and nutritional risk in enhanced recovery after surgery. Methods: A total of 130 patients with gastric cancer hospitalized in department of surgery of Ningbo First Hospitalfrom September 2016 to May 2018 were selected and divided into early enteral nutrition support group (EEN) which was placed with jejunal nutrition tube during the operation, and enteral nutrition started within 12-24 hours after the operation, and parenteral nutrition support group (PN) which was given parenteral nutrition support one day after surgery. Patients in both groups were given nutrients of equal heat and nitrogen.The incidence of nutrition-related complications, the incidence of infection-related complications, the length of postoperative hospital stay and the time of anal exhaust were compared between the two groups. Results: The incidence of nutrition-related complications was 10 cases (15.38%) and 4 cases (6.15%)in EEN group and PN group, that was not statistically different (P=0.157). The incidence of infection-related complications was 3 cases (4.61%) and 5 cases (7.69%) in EEN group and PN group, that was not statistically different (P=0.715). The postoperative hospital stay was 11 days (range, 10-15) and 12 days (range, 11-13)in EEN group and PN group, that was not statistically different (P=0.233). The first anal exhaust time and defecation timewere 64 hours (range, 52-77) and 87 hours (range, 76-100) in EEN group and 72 hours(range, 60-86) and 96 hours(range, 86-120) in PN group, that was statistically different(P=0.001, P=0.034). Conclusion Enhanced recovery after surgery, early enteral nutrition after gastric cancer surgery may promote the recovery of intestinal function, but the complications and hospital stay after operation are not improved.

Objective To investigate the status quo of nutritional risks and malnutrition of orthopedic inpatients and to provide an objective basis for standardizing nutritional support for orthopedic inpatients. Methods Patients who were hospitalized in the Department of Orthopedics, Ningbo First Hospital between November 2013 and December 2015 were continuously selected as respondents by convenience sampling. Their general data were recorded in an electronic data collection system (EDC). Then the patients were assessed for nutritional risks with nutritional risk screening 2002 (NRS 2002), and their status quo of malnutrition was identified according to recommendatory standards of guidelines.Results Totally 451 out of the 3083 patients suffered from nutritional risks, and the incidence of nutritional risks was 14.63%. 59 of them were diagnosed with malnutrition. Patients with hip fracture showed the highest incidence of malnutrition, followed by those with pelvic fracture and thoracolumbar fracture, and their incidences of nutritional risks were 56.55%, 51.61% and 27.93%, respectively. There were statistically significant differences between patients of different ages (P<0.05). The incidences of hip fracture and thoracolumbar fracture patients aged above 70 were 79.10% (140/177) and 74.19% (92/124), respectively, higher than those of patients under 70 years old (P<0.05). Conclusions Orthopedic inpatients and elderly patients, especially those with hip fracture, pelvic fracture and thoracolumbar fracture, show high incidence of nutritional risks. Therefore, the nutritional support for orthopedic inpatients should be further standardized.

Most of general surgical patients in perioperative period have nutritional risk. An appropriate nutritional risk screening may contribute to developing a nutritional support plan. Reasonable perioperative nutritional support can improve nutritional status, reduce complications, shorten hospitalization time and promote recovery of patients, and so that patients can be benefitted from this treatment. This paper will review the present situation of nutritional risk, and the methods and effects of nutritional support for patients in perioperative period, and so as to provide reference and guide for nutritional support.

Day surgery is a new medical mode that patients finish the hospitalization, surgery, treatment and discharge in one day, which can simplify the medical procedure and save medical resources. The implemtation method of medical care safety guarantee is an influence factor of the continuous development of day surgery. This article discussed how to ensure the day surgery medical quality and safety from several aspects including the service facility requirement of day surgery, management mode features, the importance of the standardization of day surgery procedure and system, implemtation of high-quality medical care, discharge standard and community transitional mode to ensure the recovery of patients. With the perfection of service facility and management function, standardized procedure and system, and the teamwork of nursing, matched high quality medical care and safety of day surgery can be achieved, which can support and provide safety guarantee for the development and promotion of day surgery so as to better develop the day surgery.

Objective To formulate a prevention and control guideline for deep venous thrombosis (DVT) in lower extremities in bedridden elderly patients and to explore its effects. Methods The problems existing in prevention and control of DVT in bedridden elderly patients were analyzed by search for literature, interviewing medical and nursing staff in the ward and reviewing DVT cases in bedridden elderly patients. The prevention and control guideline was formulated based on the evidence-based practice guideline. Relevant health videos were made and quality control measures were formulated by building DVT prevention and control teams and processes for bedridden elderly patients and adopting Caprini's and Padua's risk assessment tools. The prevention and control guideline was put into clinical use since February 2017. The incidence of DVT and blood stasis in bedridden elderly patients before (from May 2016 to January 2017, n=112) and after (between February and November 2017, n=99) the implementation of the guideline. Results After the prevention and control guideline was implemented, the positive rate of blood stasis in the bedridden elderly patients rose from 6.3% (7/112) to 15.2%(15/99), while the incidence rate of DVT dropped from 8.9% (10/112)to 2.0%(2/99) (χ2=4.458, 4.676;P＜ 0.05). Conclusions The prevention and control guideline based on the DVT prevention and management guideline can reduce the risks of DVT in bedridden elderly inpatients.

Objective? To explore the application effects of bundle care strategy to enhanced recovery after surgery (ERAS) based on evidence-based nursing practice for patients with gastric cancer during perioperative period. Methods? From July 2017 to June 2018, a total of 100 patients undergoing radical gastrectomy in Ningbo First Hospital were selected and divided into control group and observation group according to admission time, with 50 cases in each group. The control group received routine enhanced recovery nursing based on guidelines. Bundles of care was determined and implemented in the observation group based on the embodiment of ERAS after literature review combined with expert consultation. The first anal exhaust time, defecation time, ambulation time, hospitalization days, ADL score on the third day after operation, pain score at 24 and 48 hours after operation, and complications of infection were compared between the two groups. Results? The first anal exhaust time, defecation time and ambulation time of the observation group were 66 (53,78) h, 88 (76,100) h and 29 (24,36) h, which were all lower than those of the control group [72 (60,90) h, 96 (82,120) h and 36 (24,48) h], and the differences were statistically significant (P＜0.05). The ADL score on the third day after operation was (65.88±14.37), which was higher than that of the control group (59.18±14.31), and the difference was statistically significant (P＜0.05). The hospitalization duration of the observation group was 11 (10,12) days, which was shorter than that of the control group 12 (11,13) days, and the difference was statistically significant (P＜0.05). There was no statistical significance in the difference in the pain score at 24 and 48 hours after operation and the complications of infection between the two groups (P＞0.05). Conclusions? Bundle care strategy of enhanced recovery after surgery for patients with gastric cancer can promote postoperative gastrointestinal function recovery, improve postoperative self-care ability and shorten postoperative hospital stay.