Objective To investigate the quality of nursing care after the application of tracer methodology in patients undergoing chemoradiotherapy with peripherally inserted central catheters (PICC),evaluate the nurses' adherence to the procedural protocol of PICC,and calculate the number of infectious complications related with the placement.Methods We compared the nurses' adherence to the procedural protocol and the number of infectious complications before (April 2014 to June 2015) and after (July 2015 to October 2016) the tracer methodology was applied at the Chemoradiotherapy Center of Ningbo First Hospital in July 2015.Results After the tracer methodology was introduced to the care of patients with PICC,the nurses had better adherence to the procedural protocol,as shown in the rise of quality control score from (94.00± 3.35) to (97.87± 1.42).The incidence of infectious complications dropped significantly (all P＜0.001).Conclusion The clinical application of tracer methodology can improve the quality of nursing for patients with PICC,reduce the incidence of PICC-related infectious complications,and promote patient safety.

Objective To explore the effect of individualized multiple-nutritional evaluation for patients with bone cancer. Methods Totals of 94 cases with bone cancer were divided into the control group and observation group(with 47 patients in each group) from January 2012 to December 2013. The control group received conventional nursing during chemotherapy, while the observation group was given individualized multiple-nutritional evaluation. The differences in serum albumin, level of dietary knowledge and the postoperative complications were compared at different periods of time. Results In the observation group, the serum albumin at admission and 1 week after admission were not significantly different (P >0. 05). After 4 weeks, the serum albumin of observation group was (33. 41 ± 1. 31) g/L, which was significantly different with the control group (t=5. 117,P<0. 05). In the observation group, the dietary knowledge at admission was not significantly different (P>0. 05). After 1 and 2 weeks, the dietary knowledge of observation group were (10.47 ±1. 33) and (9.56 ±1.28), which were significantly different with the control group (t =2. 935, 3. 297,respectively;P<0. 05). The complication of abdominal pain, diarrhea, abdominal distension and nausea and vomiting in the observation group were significantly lower than those of the control group (χ2 =6. 351, 4. 039,4. 663,4. 417,respectively;P<0. 05). Conclusions The individualized multiple-nutritional evaluation cannot only effectively improve the nutritional status of patients with bone cancer, but also reduce incidence of gastrointestinal complications.

Objective Through establishment of prevention and control guideline for radioactive oral cavity mucositis ( radiotherapy-induced oral mucositis, RTOM ) , to guide nursing staff to strengthen the prevention and control for RTOM in patients with head and neck tumor, thereby improving the quality of nursing. Methods Through evidence-based literature retrieval, interview chemoradiation division staff and RTOM cases, the common problems in nursing management of RTOM prevention and control were concluded and analyzed. According to related evidence-based nursing practice, prevention and control guidelines was established. Through establishment of a multidisciplinary team and process for prevention and control of RTOM, strengthening RTOM specialty and related assessment scale training, health education propaganda material and quality control measures were made.Results After the implementation of prevention and control guidance, the incidence of grade Ⅲ RTOM reduced to 16. 7% from 40. 0%; pain score ( Numerical Rating Scale, NRS ) reduced from (3.90±0.76) points to (1.67±1.07) points (P<0.05).Conclusions The prevention and control guideline has better clinical guidance on RTOM in patients with head and neck tumor.

Objective? To explore the effects of clinical pathway in cancer pain management among cancer patients. Methods? We selected 114 cancer patients with pain and opioids pain management in Radiotherapy and Chemotherapy Center at Ningbo First Hospital of Zhejiang Province. A total of 56 cancer patients with pain from March to December 2018 were in observation group with nursing based on self-design clinical pathway; a total of 58 cancer patients with pain from May 2017 to February 2018 were in control group with routine nursing. The Numerical Rating Scale (NRS) was used to compare the effects of pain management of patients between two groups. We also investigated the medication compliance and pain management satisfaction of patients between two groups. Results? As time progressed, the NRS scores of cancer pain patients in the two groups decreased, and the interaction, time and intervention differences between the two groups were statistically significant (P＜ 0.01). One day before discharge, the score of NRS in breakout pain attack of patients of observation group was (4.78±0.59) lower than that (5.56±0.74) of control group; times of breakout pain of patients of observation group was (2.70±0.71) times per day less than (3.21±0.84) times per day of control group; the differences were statistical (P＜0.01). The medication compliance of patients of observation group was (6.69±0.97), higher than (6.02±1.10) of control group; patients' satisfaction with pain management of observation group was (87.84±7.21), higher than (75.93±6.95) of control group;the differences were also statistically significant (P＜ 0.01). Conclusions? Application of clinical pathway in pain management and nursing for cancer patients with pain can effectively management patients pain and improves patients' medication compliance and satisfaction with nursing.