Objective To explore the application of nursing management staff and nurse joint rounds in afternoon and night rounds model. Methods Elite nurses with high comprehensive qualities recommended by every department joined into the nurse management personnel,and took afternoon and right rounds in line with the specific contents and requirements of shifts and rounds. Results After the implementation of joint afternoon and evening rounds model, the overall scores of nursing control quality, patient's satisfaction and nursing staff's satisfaction were higher than those before the implementation; the number of care and adverse events was lower than that before.the implementation (t = 3.19, x2 =4.69, 7.85, 10.37,P ＜0.05 or P ＜0.01). Conclusions Joint afternoon and night rounds model puts an end to the blind area of nursing management, ensures the continuity and safety of nursing management, strengthens nursing staff' s awareness of participation in all nursing management, promotes continuous improvement and enhancement of quality of care, reduces the work pressure of nurses and managing staff , achieves the effects of complementary synergy. And it also promotes learning,which trains a large number of nursing staff and provides the nursing personnel with reserve forces.

Objective To explore the effect of musicotherapy to BP, HR and anxiety extent of patients in childbirth without pain. Methods 200 patients were divided into two groups, control group and music group.Music background table was used to evaluate puerperants' music background and favorite and personalized musicotherapy program was made. Anxiety and depression self-evaluated table was used and blood pressure, heart rate were measured before and in birth. Results Anxiety extent in operation is obviously reduced in music group (t = 2. 10,P ＜ 0. 01 ) ;BP and HR were stable, the difference between two groups was statistically significant( t =9. 51,1.11 ,P ＜0. 01 ); the first and second stage of labor reduce(t =2. 06,2. 11 ,P ＜0. 05). Conclusions Musicotherapy can obviously cut down anxiety and fear extent in operation and improve patients' physiological condition.

Objective:To investigate the quality of rehabilitation medical service in tertiary general hospitals in Gansu Province. Methods:Stratified sampling was used to sample tertiary general hospitals in Gansu Province for on-site surveys in 2017. A quality evaluation index system was established in the view of medical service providers, including 17 indicators, based on Donabedian model and experts' opinions. Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) and Rank-sum Ratio were applied to make a comprehensive evaluation on the overall service quality of the hospital rehabilitation medical service. Results:A total of 27 tertiary general hospitals were sampled, in 13 cities/prefectures of Gansu Province. For the structure quality, the compliance rate of the business operation area and the number of beds in the rehabilitation medicine department were 77.78% and 51.85% respectively; while the compliance rates of the physicians, therapists and nurses were all less than 50%. For the process and results quality, the compliance rates were all more than 85%. For the overall quality of rehabilitation medical service, five hospitals were classified as Good, located in Lanzhou, Tianshui and Jiayuguan; 18 hospitals were classified as Medium, located in Longnan, Longdong, Lanzhou and surround, Linxia and Hexi regions; four hospitals classified as Poor, located in Lanzhou and Tianshui. Conclusion:The overall quality of rehabilitation services in the tertiary general hospitals of Gansu Province needs to be improved, and the development of rehabilitation services is uneven in various regions. Comprehensive evaluation provides an important reference to promote the rational distribution of rehabilitation medical resources and improve the quality of rehabilitation medical services.