Objective:To explore the status and influencing factors of nurses′ cognitive ability of nursing interruptions in operating room.Methods:From March to May 2020, convenient sampling was conducted, a questionnaire was used to investigate the cognitive ability of operating room registered nurses in some provinces and cities in China. The influencing factors were analyzed by single factor analysis and multiple stepwise linear regression analysis.Results:Finally, 2 827 questionnaires were collected from 1 municipality directly under the central government and 15 provinces, involving 42 municipal and county hospitals. The nurses′ cognitive ability of nursing interruptions in operating room scored 105.73 ± 13.39, which was in the middle level. A total of 2 427 (87.37%) operating room nurses thought it necessary to receive training on nursing interruptions, but only 796 (28.16%) nurses had received training on nursing interruptions. Multiple stepwise linear regression analysis showed that different job categories ( B=-0.714, P<0.001), whether to pay attention to nursing interruptions ( B=5.449, P<0.001), the frequency of experience nursing interruptions ( B=-1.916, P<0.001)and whether to participate in the training of nursing interruptions ( B=-4.806, P<0.001) were the influencing factors of operating room nurses' cognitive ability of nursing interruptions. Conclusions:The operating room nurses' cognitive ability of nursing interruptions is in the middle level. The current situation of training is not good, but the training demand is high. Managers should strengthen the systematic training of nurses on nursing interruptions, especially those with junior nurses in operating room, to improve nurses' attention and cognitive ability of nursing interruptions.

Objective To retrieve, evaluate, and summarize evidence on preventive management of high output and dehydration in ileostomy patients from both domestic and international sources. Methods Based on the "6S" evidence model, a top-down approach was employed to retrieve evidence on prevention and management of high output and dehydration in ileostomy patients. Databases searched included BMJ best practice, UpToDate, National Guideline Clearinghouse (NGC), National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), Registered Nurses' Association of Ontario (RNAO), Wound Ostomy and Continence Nurses Society (WOCNS), World Council of Enterostomal Therapists (WCET), Medlive Clinical Guidelines website, Joanna Briggs Institute (JBI), Cochrane Library, Embase, PubMed, Web of Science, CNKI, Wanfang Data, China Biology Medicine (CBM), and VIP Database. The search period was from January 2019 to April 2024. Results A total of 13 articles were included after retrieval and screening, comprising 2 guidelines, 2 expert consensuses, 4 systematic reviews, 4 evidence summaries, and 1 clinical decision aid. After translation, summarization, and organization of the included articles, 19 pieces of evidence across 11 categories were formulated, focusing on four items: definition and risk factors of high output in ileostomy, prevention and management strategies related to high output in ileostomy, prevention and management strategies related to dehydration in high-output ileostomy, and follow-up strategies for prevention of high output and dehydration after ileostomy surgery. Conclusion The evidence summarized based on the "6S" evidence model for prevention and management of high output and dehydration in ileostomy patients can provide a reference for clinical practice among healthcare professionals and medical decision-makers, thereby enhancing nursing quality and reducing patient rehospitalization rates.

Objective:To systematically evaluate and integrate the qualitative research of Chinese nurses' experience of "Internet+ nursing service", aiming to provide reference for medical institutions to further promote and improve the "Internet+ nursing service" model.Methods:Chinese nurses' experience of cognition, practice and management of "Internet+ nursing service" was retrieved through computers in Cochrane Library, PubMed, Embase, Scopus, Web of Science, CINAHL, China National Knowledge Infrastructure, WanFang Data, VIP, and China Biology Medicine disc. The retrieval time limit was from the establishment of the database to December 31, 2021. The included articles were integrated and analyzed according to the quality evaluation criteria for qualitative research of the Joanna Briggs Institute (JBI) Evidence-Based Health Care Center in Australia and integration methods.Results:A total of 11 articles were included and 46 results, 10 categories and 3 integration results were extracted, including integration result 1: nurses' positive experience of "Internet+ nursing service"; integration result 2: nurses' negative experience of "Internet+ nursing service"; integration result 3: nurses' demands and expectations for "Internet+ nursing service".Conclusions:Chinese nurses have both positive and negative experiences of "Internet+ nursing service", and have a clear intention to carry out the "Internet+ nursing service" project. The government and hospitals need to further provide policy support and platform support for nurses to promote the improvement and effective promotion of the "Internet+ nursing service" model.

Objective: To investigate the effect of FOCUS(F:find; O:organize; C:clarify; U:understand; S:select)-PDCA on reducing the adverse event rate caused by junior nurses. Methods: A historical control design was used, traditional method to manage adverse events among junior nurses from January to June 2017. Interdisciplinary team combined with FOCUS-PDCA courses was established from July to December 2017. In the course problems were found and analyzed, the present procedures and standard were issued and improved. And these data were summarized and analyzed to improve the quality of management continuously. Results: Before applying the FOCUS-PDCA model, the total incidence of adverse events caused by junior nurses, bachelor′s degree or above, nurse practitioners, and working career of 1-3 years were respectively as follows: 42.66%(285/668), 46.67%(112/240), 40.54%(105/259), 51.61%(176/341). After using this model, the above four indicators were 33.04%(229/693), 33.33%(84/252), 27.04%(73/270), 38.97%(136/349) respectively. There were significant differences before and after the FOCUS-PDCA (χ²=4.20-13.39, P<0.01 or 0.05). Conclusions Multidisciplinary team-based FOCUS-PDCA management reduces the adverse event rate caused by junior nurses and improves the quality of management continuously.

Objective:To explore the MRI features of neonatal deep cerebral arterial infarctions.Methods:The medical and MRI datas of 23 neonates with deep cerebral arterial infarctions from January 2011 to December 2018 in Beijing Children′s Hospital, Capital Medical University were retrospectively analyzed. Both 11 males and 12 females with ages between 1-28 d were recruited and MRI were performed within 2-20 d after symptom onset. The MRI featurs including location, morphology, signal characteristics, enhancement features and other accompanied signs were reviewed.Results:A total of 15 cases with arterial infarction and 8 cases with complication of purulent meningitis were identified. The median age at presentation were 2 d and 7 d respectively. The unilateral involvement were demonstrated in all neonates with arterial infarctions. Among them, 11 had deep infarcts and the main branch of the middle cerebral artery was involved in 4 neonates. MRI showed slightly hypo-intensity on T 1WI and slightly hyper-intensity on T 2WI with indistinct boundary and focal punctate hyper-intensity on T 1WI and hypo-intensity on T 2WI. In 8 cases secondary to purulent meningitis, unilateral involvement was found in 5 cases and bilateral involvement in 3 cases. All cases showed hypo-intensity on T 1WI and hyper-intensity on T 2WI with indistinct boundary. Among them, 7 cases were heterogeneous, with small cystic changes which appeared as slightly hyper-intensity on T 1WI and slightly hypo-intensity on T 2WI peripherally, as well as nodular or patchy restricted diffusion. Marked swelling of the lesion was found in 6 cases. Multiple patchy or ring enhancement was revealed in 5 cases. Iso-intensity and restricted diffusion in posterior horn of the lateral ventricle were found in 2 cases. Restricted diffusion in frontotemporal subarachnoid space was found in 5 cases. One case showed subdural effusion. Conclusion:Neonatal deep cerebral arterial infarctions have certain characteristic appearance on MRI. Lesions secondary to purulent meningitis can be bilateral involvement with heterogeneous MRI intensities, and different period of infarction signs could be found concurrently. MRI is beneficial to the differential diagnosis.

Objective:To analyze the diagnosis and treatment of neonatal neuroblastoma (NB) by summarizing its clinical characteristics.Methods:This study retrospectively recruited 14 neonates with NB in Beijing Children's Hospital (National Center for Children's Health) from February 1, 2015, to February 1, 2020. Medical records and follow-up data as of February 29, 2020, were collected, and clinical staging based on International Neuroblastoma Staging System, risk grouping based on American Childhood Oncology Group risk grouping system, diagnosis, treatment, and prognosis were analyzed. According to whether surgical treatment was performed in the neonatal period or not, these subjects were divided into surgical and non-surgical groups. A descriptive statistical analysis was used for data analysis.Results:(1) Neonates with NB accounted for 0.063% (14/22 006) of the total number of newborns admitted to the hospital during the same period. The 14 cases were all full-term aged 15 d (8 h-23 d) at admission. Tumors were found in seven cases in prenatal examinations, while others presented with shortness of breath (three cases), abdominal distension (two cases), fever (one case), and dysuria and difficult defecation after birth (one case). (2) The primary tumor sites included the adrenal gland (eight cases), posterior mediastinum (three cases), retroperitoneum (two cases), and sacrococcygeal (one case). Three cases had extensive diffuse liver metastasis at admission. (3) Except for two cases who refused to examine, the serum neuron-specific enolase of 12 cases was 57.2 ng/ml (35.9-158.3 ng/ml) during hospitalization, and the urine vanillyl-mandelic acid creatinine of four cases was 2 304.940 (685.748-9 595.314). (4) Primary tumor sites were found in 14 cases by imaging examination. Bone scanning was performed in three cases, including one with a concentrated shadow of the right sacroiliac joint and two with no abnormalities. Ten cases underwent bone marrow aspiration and all with normal results. (5) Of the ten neonates received surgery (the surgical group), nine had the primary tumor wholly removed, without chemotherapy after the operation, and the tumor-free survival period was 19 months (1-45 months). One case (case 5) had a substantial primary tumor that could not be completely resected. The patient underwent a second surgery five months after the first operation due to disease progression and received postoperative chemotherapy. The child had stopped chemotherapy for 24 months and survived without a tumor. (6) In the non-surgical group (cases 11 to 14), the tumor in case 11 who refused chemotherapy shrank spontaneously after discharge, and the patient survived for 20 months with the tumor. The parents of the case 12 withdrew treatment during hospitalization, while the primary tumor and metastases disappeared after discharge, and the specific tumor markers gradually decreased to normal levels. The patient has been tumor-free survived for 25 months. Case 13 received mediastinal tumor resection and chemotherapy during infancy. At the end of the follow-up, chemotherapy had been stopped for 12 months, and the patient survived without a tumor. Case 14 withdrew treatment and died. (7) Among the ten cases in the surgical group, one patient's pathological result indicated a composite tumor, while the others were low differentiated neuroblastoma. There was no MYCN gene amplification, 1p36 deletion, or 11q23 deletion in the ten cases. (8) Among the ten children in the surgical group, nine were in stage 1, and one was in stage 4S (case 5). Nine cases were classified into extremely low-risk groups, while the other was in the low-risk group. The four cases in the non-surgical group could not be grouped by risk. Conclusions:Clinical manifestations of neonatal NB are often atypical. NB in stage 4S might resolve spontaneously, and expectant observation may be considered. The overall prognosis of neonatal NB is generally good, but further researches are needed.

Objective:To explore the status and influencing factors of incontinence-associated dermatitis among elderly inpatients in 52 hospitals nationwide, and to analyze the nursing of elderly inpatients with incontinence, so as to provide a reference for clinical intervention.Methods:On March 31, 2021, convenience sampling was used to select 14 675 elderly inpatients from 52 hospitals across the country as the research object. The self-designed Incontinence-associated Dermatitis Questionnaire for Elderly Inpatients was used to collect general demographic data, health status, incontinence, and skin nursing. Binomial Logistic regression was used to investigate the influencing factors of incontinence-associated dermatitis in elderly inpatients.Results:Among 14 675 elderly inpatients, the prevalence rates of xerosis cutis, incontinence and incontinence-associated dermatitis were 38.78% (5 691/14 675) , 11.06% (1 623/14 675) and 1.91% (280/14 675) , respectively. The prevalence of mild, moderate and severe incontinence-associated dermatitis were 1.27% (186/14 675) , 0.55% (81/14 675) , and 0.09% (13/14 675) , respectively. Among the nursing of 1 623 elderly inpatients with incontinence, the items with low implementation rate were the use neutral lotion to clean skin (14.17%, 230/1 623) , use of skin protectant after moisturizing (17.68%, 287/1 623) , moisturizing after cleansing the skin (28.90%, 469/1 623) . The results of binomial Logistic regression analysis showed that xeroderma, fecal incontinence, urinary and fecal incontinence, ≥2 kinds of combined medication, and hospital stay >30 days were risk factors for incontinence-associated dermatitis in elderly inpatients.Conclusions:The risk factors of incontinence-associated dermatitis in elderly inpatients mainly include xerosis cutis, type of incontinence, ≥2 kinds of combined medication, and hospital stay >30 days.

Objective:To understand the current situation of nurses in 52 hospitals in China on mastery of knowledge about skin injury in the elderly based on the background of mixed-mode homogenization training.Methods:Using the convenient sampling method, a total of 1 067 nurses from 52 hospitals in China were selected as the research objects in January 2021. A self-designed questionnaire on knowledge of skin injury in the elderly was used to investigate the nurses through the questionnaire star and univariate analysis was used to analyze the influencing factors. A total of 1 067 questionnaires were distributed and 1 067 valid questionnaires were recovered, and the effective recovery rate was 100%.Results:The knowledge scores of pressure injury, incontinence-associated dermatitis, skin tear and xerosis cutis among 1067 nurses were (95.66±7.37) , (95.65±9.15) , (91.37±15.45) and (87.67±15.91) , respectively. The results of univariate analysis showed that hospital grade was the influencing factor of nurses' knowledge score of pressure injury, skin tear and incontinence-associated dermatitis ( P<0.05) , educational background was the influencing factor of nurses' knowledge score of skin tear ( P<0.05) , professional title was the influencing factor of nurses' knowledge scores of pressure injury, incontinence-associated dermatitis and xerosis cutis ( P<0.05) . Conclusions:Hospitals at all levels need to strengthen the theoretical and practical knowledge training for nurses on skin xerosis and skin tear in the elderly, especially for nurses with primary titles and lower education in grassroots hospitals.