Objective To know the influencing factors of nursing associations of different provinces and cities undertaking transferred government functions,and to explore the new direction of nursing management system reform based on the association platform.Method 10 experts from 9 provinces and cities were interviewed,and statistics was analyzed by three-level coding combining with QSR NVivo10.0 software.Result 3 themes were collected (internal factors,external support factors and others,such as an independent legal status,financial support,etc).Conclusion Nursing associations,as participants of medical organization and hospital management,must make their own capabilities clear,continuously strengthen their own ability in order to provide better service,and promote the development of medical and health career.

Objective To build position system based on a large ship ocean nursing needs.Methods Two rounds of expert consultation were carried out through the literature material method,field survey,comparative research method,and Delphi method to build nursing station system of the large ship.Results The expert authority coefficient was 0.81.Two rounds of expert coordination coefficients were 0.55,0.52.The nursing position system contained three parts:level Ⅰ position,level Ⅱ position and the post job responsibilities.Conclusions The system contains 21 stations,the expert opinions are concentrated with high credibility,it can provide certain theoretical support for the nursing personnel selection,training,and ship jobs management of large ship.

OBJECTIVE To provide references for clinical diagnosis of catheter-related bloodstream infections(CRBSIs) and focus on studying the spectras of pathogenic bacteria and the drug sensitiveness. METHODS A total of 137 patients enrolled from Jan 2005 to Dec 2007 in our hospital with positive catheter cultures were admitted to our retrospective analysis.Pathogenic bacteria,contaminant bacteria and the drug sensitiveness of main pathogenic bacteria were analyzed. RESULTS From them 80 patients were diagnosed CRBSIs.Among 92 strains of pathogenic bacteria,43(46.7%) strains were Gram-positives,31(33.7%) coagulase negative staphylococci(CNS) strains,31(33.7%) Gram-negative bacilli strains and 18(19.6%) were Candida strains. CONCLUSIONS CNS are the most common bacteria of CRBSIs,and the second are Candida.The common pathogen show multi-drug resistance.

Objective To investigate the status of clinical practice of master of nursing specialist (MNS) and provide references for completing the clinical practice patterns of master of nursing specialist in intensive care units.Methods Totally 56 clinical nursing postgraduate students were investigated from 10 nursing colleges by questionnaire survey.Results 46.43％ students were not satisfied with effect of clinical practice;69.64％ students though there was little difference between postgraduate and undergraduate students in clinical teaching method; 82.14％ students considered clinical teachers couldn't meet their leaming needs; the main reasons affecting the effect of clinical practice included inadequate teaching method (73.21％),impertinent teaching contents (69.64％) and unreasonable time arrangement (51.79％);55.36％ students wanted to be nursing educators; 50.00％ students wanted to be nursing specialist.Conclusions The effect of clinical practice of clinical nursing postgraduate students did not achieve the target.Clinical teaching couldn't meet the learning needs.Students are lack of recognition to capability and quality of master of nursing specialist.We should highlight the special characteristics of intensive care nursing,regulate the clinical teaching method and strengthen the publicity of master of nursing specialist to optimize structure of nursing talent.

Based on the conception analysis of the organizational change leadership of the upper-and mid-level nursing manager,this review described connovations of the organizational change leadership and its applications in nursing field at home and abroad,and pointed out the current research status,limitations and the inspirations we got,so as to provide references for promotion and evaluation of the upper-and midlevel nursing manager's organizational change leadership.

OBJECTIVE To investigate bacterial contamination of throat spray in different patient groups before and after using it and explore the satisfactory disinfection methods for decreasing the rate of hospital acquired infection.METHODS The methods were used in accordance with Disinfection Technology Criteria.We compared the germicidal effect of five kinds of methods.RESULTS Bacterial contamination was very serious after using throat spray,many bacteria,even pathogens,as well as the normal flora from the region of nasopharynx had been found there.Bacterial contamination was more serious in ENT department patient than in endoscopy patient after using throat sprays.Burning,alcohol,iodophor and disinfectants containing iodine with alcohol were better than oxidized potential water method on disinfection effect.CONCLUSIONS Much attention should be paid to the contamination of throat spray,selecting the most effective disinfection methods,hospital infections caused by invasive manipulation could be prevented when correct methods are adopted.

Objective To compare the cleaning effect of before and after improvement of P′750 type endoscopic infusion pump sensing infusion. Methods 240 cases of urinary calculi patients were divided into experimental group (120 cases) and control group (120 cases) according to the random number table method. Experimental group made improvements on P′750 type endoscopic infusion pump sensing infusion, Took latex transmission pipe, sampling module, metal fittings and parenteral nutrition infusion bags, disposable connecting pipe connection, and surgery using improved sensing infusion. The control group used unimproved sensing infusion. Results Visual inspection of cleaning pass rate before and after improvement sensing infusion were 85.83% (103/120), 99.17% (119/120), 5 times with light magnifier inspection were 78.33%(94/120), 97.50% (117/120), tampons method inspection were 75.83% (91/120), 95.83% (115/120), ATP bioluminescence monitoring were 70.83% (85/120), 91.67% (110/120), dry pass rate were 90.83%(109/120), 100.00% (120/120), cleaning and drying pass rate were significantly improved (χ2=18.296, 29.159, 32.986, 40.976, 11.528, all P<0.01). Cleaning time before and after improvement sensing infusion were (1 020.40±8.22) s, (539.30±8.70) s. Dry time were (1 199.35±26.70) s, (61.50±5.79) s. Cleaning and drying time were significantly shortened (t=440.340, 456.206, all P<0.01). Conclusion Improvement sensing infusion increased the quality of cleaning and drying, shortened the cleaning and drying time, ensured the quality of surgery using equipment, improved work efficiency, and provided a guarantee for the safe and smooth implementation of the surgery.

Objective Constructing a scientific and practical clinical practice patterns for intensive care nursing masters with professional degree.Methods Based on the competence based education,a clinical practice patterns for intensive care nursing master with professional degree was developed by literature review,questionnaire survey,unstructured interview and Delphi technique.Results 16 experts from 10 third-level and first-class hospitals and 1 Nursing College were consulted,the retrieving rates of questionnaire were 93.75％,100.00％,respectively.The authoritative coefficients were 0.94 and the coordination coefficients were 0.257.The index system consisted of 6 first dimensions,47 second-dimensions and 112 items.Conclusions The positivity and authority of experts in this study were in high degree,the concentration and harmonization of experts' opinions were relatively high.The results had high reliability and feasibility.It can be used to provide objective and quantitative reference for intensive care nursing master with professional degree.

Objective To explore whether perioperative bright light therapy could inhibit the occurrence of postoperative delirium in tumor patients undergoing open hepatobiliary surgery. Methods Totally120 elderly tumor patients scheduled for open hepatobiliary surgery and postoperative ICU treatment were recruited and randomized into bright light and control group with 60 cases per group in accordance with the random number table.Bright light was delivered to the patients at an intensity of 10 000 lux from 2 days before surgery to postoperative day 7.Each intervention began at 7 am and lasted for 2 hours.Delirium was screened using the Confusion Assessment Method for Intensive Care Unit(CAM-ICU) during the first 7 days after surgery. The differences in the incidence of postoperative delirium, the duration of delirium and the length of ICU as well as postoperative hospital stay were compared. Results Demographic characteristics and surgical outcomes were similar between groups. The incidence of postoperative delirium were 46.67%(28/60)and 23.33%(14/60)for control group and bright light group respectively with a significant difference (χ2=7.179,P=0.007). The difference was seen on postoperative days 3 (χ2=5.187, P = 0.023) and 4 (χ2=8.749,P = 0.003). The incidences of delirium on postoperative days 3 for bright light and control group were 5.08%(3/59)and 18.64%(11/59)respectively.On postoperative day 4, the incidences of delirium for bright light and control group were 0 (0/58) and 14.04% (8/57) respectively.There was no difference in the duration of delirium(χ2=1.248,P=0.264),the length of ICU stay (χ2=0.036,P=0.849)or the hospital stay(χ2=1.706,P=0.192). Conclusion Bright light is useful in preventing postoperative delirium in elderly tumor patients undergoing open hepatobiliary surgery.

Objective:To explore the barrier factors of career development among nurses during career establishment period so as to provide a reference for promoting the professional development of nurses.Methods:From March to April 2019, we selected 10 nurses in the career establishment period of a GradeⅢ Class A hospital in Beijing by purposive sampling. The grounded theoretical method in qualitative research was used to carry out the face-to-face semi-structured interview and live recordings. The interview data were anonymously transcribed, coded step by step and subjects of them were extracted with the help of NVivo 11.0 qualitative analysis software.Results:Barrier factors of career development of nurses during career establishment period included three themes, namely, career development motivation changes (including career development willingness, career identity and family orientation) , work investment changes (including time investment and energy investment) and impacts of career development environment (including organizational support and team atmosphere) .Conclusions:Inadequate motivation for career development, insufficient work investment and poor nursing career environment are the barriers to the career development of nurses during career establishment period. This suggests that nursing managers can take work incentives from the perspective of positive psychology, create a good team atmosphere, fully excavate the career development motivation of nurses during the career establishment period, help nurses turn passive to active during career establishment and finally achieve career and family development.