Objective To systematically evaluate the effectiveness of intermittent nasogastric feeding on enteral nutrition of critical patients. Methods The relevant randomized controlled trials were searched in the Cochrane Library, PubMed, EMbase, Web of Science, JBI Library and the databases of China National Knowledge Infrastructure (CNKI), China Scientific Journal Database by VIP (VIP), Wanfang Database. The studies were selected according to the inclusion and exclusion criteria by two reviewers. Meta- analysis was conducted by using RevMan 5.2. Results Nine RCTs were included involving 558 patients. The results of meta- analysis showed that intermittent nasogastric feeding was greater than continuous pump feeding in the incidence of constipation, OR=0.32, 95%CI 0.14~0.71, P<0.05, the difference was significant. However, they were alike in the incidences of diarrhea, aspiration pneumonia, gastric residuals, vomiting, abdominal distension and effects of nutrition, there was no statistical difference (P>0.05). Conclusions Intermittent nasogastric feeding and continuous pump feeding did not affect the incidence of diarrhea, aspiration pneumonia, gastric residuals, vomiting, abdominal distension and the effects of nutrition. However, the incidence of constipation was significantly less in patients receiving intermittent nasogastric feeding.

Objective To investigate the clinical effect of a new type of disposable heparin freedialysis tube in uremic patients without heparin dialysis. Methods A total of 110 patients withoutheparin dialysis were divided into control group and observation group by random digits table method with55 cases each. Based on the same pre dialysis and dialysis for heparin saline flushing of discontinuoussaline on the control group using the traditional dialysis pipe for hemodialysis without heparin, theobservation group used disposable non heparin dialysis pipe for hemodialysis without heparin. The numberof patients with venous catheter blockage, blood loss and completion of dialysis time in two groups wasrecorded. Results The number of patients with venous catheter blockage, blood loss and completion ofdialysis time was 6, 6, 47 cases in control group and 0, 0, 54 cases in observation group. The differences were statistically significant (χ2=4.407, 4.407, 4.356, P<0.05). Conclusions The new disposableheparin free dialysis tube can reduce the loss of blood and prolong the treatment time, and the operation issimple, safe and effective, and has good application value and application prospect.

Objective To develop and apply an ICU orientation program based on the Miller pyramid competency model. Methods 45 new ICU nurses in 2013 and 2014 were selected as the experimental group. The experimental group was oriented by the new program,including the orientation of preceptors, workshop-centered orientation courses, checklists-precepting and comprehensive competency evaluation methods. 39 new ICU nurses in 2011 and 2012 were selected as the control group. The control group was oriented by the conventional program,including focused theory classes and traditional precepting.New nurses′ satisfaction with the orientation and the competency were analyzed before and after intervention in two groups. Results Satisfaction with the orientation, self-evaluated competency and peer-evaluated competency in the experimental group were(16.71±1.19) scores, (126.52±3.31) scores and (90.00±2.68) scores respectively,which were much better than the control group and had statistically significant difference in two groups. Conclusions The ICU new nurse orientation program based on the Miller pyramid competency model can improve the new nurses′ satisfaction with the orientation and the competency after the orientation.

Objective:To systematically review qualitative research on the experience and coping behaviors of moral distress among nurses, and to provide references for the formulation of targeted measures.Methods:Search nurses moral distress qualitative research in PubMed, Web of Science, CINAHL, Embase, CBM, CNKI, VIP, Wanfang Database from the establishment of the database to July 2021. The 2016 version JBI Critical Appraisal Tool for qualitative studies in Australia was used to evaluate the quality of the eligible studies. The methods of pooled integration were used to integrate the results.Results:A total of 16 studies were included, and 11 categories were summarized and refined, form three integrated results: the source of nurses′ moral distress, the experience of nurses′moral distress, and the way nurses cope with moral distress.Conclusions:The nurses themselves and their managers should pay attention to the source of moral distress and their experience, and provide appropriate intervention and support to avoid and reduce moral distress and improve the quality of care.

The change of nursing management is of great significance to improve the service quality and management level of the hospital. The authors summarized the research progress of shared governance model in hospital nursing management, including the development and connotation of the model, related influencing factors, evaluation tools and application results. The authors proposed the enlightenment of participating in shared governance to China′s nursing management, as well as related problems and suggestions for its implementation, so as to provide new ideas and scientific references for the transformation of nursing management in China.

Objective: To evaluate the effects on reduction of peripherally inserted central catheter-related venous thrombosis by hand grip exercise. Methods: A detailed search was performed to identify literature about the impact of handgrip exercise on peripherally inserted central catheter-related venous thrombosis, using the Cochrane Library and the databases of PubMed, CINAHL, Embase, CNKI, WanFang and CBM. The meta-analysis or descriptive review were performed after two authors in-dependently searching databases,extracting data and assessing quality of included studies. Results: Seven RCTs were included in a total of 789 patients. Meta-analysis showed the effectiveness of handgrip exercise on reduction of peripherally inserted central catheter-related venous thrombosis (RR=0.27, 95% CI 0.17-0.42, P<0.01); and improving vein maximum velocity (WMD=6.53, 95%CI 3.34-9.73, P<0.01) and time-mean flow velocity (WMD=6.05, 95%CI 3.24-8.87, P<0.01). Conclusions Handgrip exercise can improve axillary vein blood flow parameters and reduce peripherally inserted central catheter-related venous thrombosis. Due to a small number of included studies and heterogeneity of indicators, multi-centered, high-quality RCTs with large sample size are needed in the future to assess the effect of handgrip exercise in PICC patients.

The role of interprofessional collaboration in the health care system has been increasingly proven and has led to a shift in the way work is done in the health care industry. Following the trend of this development, interprofessional education has also been developed accordingly. As the main content of interprofessional education, inerprofessional collaboration compentence plays an important role in improving the practice level of interprofessional collaboration among medical personnel. In this paper, the research status of interprofessional collaboration compentence is summarized, and the theoretical research of interprofessional collaboration compentence and the practical research in clinical nursing are reviewed, and the thinking of interprofessional collaboration compentence of critical care nurses is put forward, in order to provide reference for the education and management of critical care clinical nurses

The emergent global public health issues have promoted the development and application of virtual nurse. This paper introduced the concept and the application form of virtual nurse, and provided an overview of the current state of application of virtual nurse centered on the core roles, including staff mentoring/staff education, patient education, real-time quality surveillance/patient safety surveillance, physician rounding, admission activities, and discharge activities. Moreover, it further analyzed the problems of the virtual nurse in the process of practice and application and made an outlook on its future application and development direction, aiming to provide reference and guidance for Chinese healthcare professionals to explore and practice in the field of the virtual nurse.

Objective The Ethical Decision-Making Confidence Scale(EDMC)was translated into Chinese,and its reliability and validity were tested.Methods The English version of EDMC was translated into Chinese and back-translated according to the Brislin model.After being reviewed by the original authors,cultural adjustments were made,and a pretest was conducted to finalize the Chinese version of the scale.To test the reliability and validity of the scale,228 nurse leaders were investigated using a convenience sampling method in a tertiary hospital in Zhejiang from April to May 2023.Additionally,20 nurse leaders were selected to provide test-retest data 2 weeks after the survey.Results The Chinese version of EDMC contained 2 dimensions,namely skill-related confidence(9 items)and behavior-related confidence(6 items).The I-CVI ranged from 0.833 to 1.000,and the S-CVI/Ave was 0.967.Exploratory factor analysis extracted 2 common factors with factor loadings ranging from 0.546 to 0.828 for each item,contributing to a cumulative variance rate of 65.449％.The Cronbach's α coefficient of the overall scale was 0.947,and the Cronbach's α coefficient for each dimension ranged from 0.911 to 0.919.The split-half reliability of the total scale was 0.882,and the test-retest reliability was 0.752.Conclusion The Chinese version of EDMC demonstrated good reliability and validity,making it suitable for a comprehensive evaluation of the ethical decision-making confidence of nurse leaders.It can provide corresponding bases for medical administrators to make educational plans and targeted intervention strategies.

Objective:To optimize the accuracy of the intelligent hand hygiene system to monitor the hand hygiene timing warning, and provide a reference basis for healthcare workers to apply the intelligent hand hygiene system.Methods:Using a single-sample diagnostic pilot study method, 62 clinical nurses wearing smart badges working in the intensive care unit of Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine in Hangzhou, from December 1, 2020 to December 31, 2021 were selected by convenience sampling methods. Direct observation was used as the gold standard. The accuracy of the warning timing of the intelligent hand hygiene monitoring system was optimized through adjusting the bed sensing rang,adjusting the time setting, adjusting the time settings according to the physical space of the ward and adding posture recognition.Results:The sensitivity of adjusting the bed sensing range was 0.935 (95% CI 0.918-0.949); the specificity was 0.008 (95% CI 0.001-0.074). The sensitivity of the temporal setting based on the physical space of the ward was 0.932(95% CI 0.915-0.946); the specificity was 0.205 (95% CI 0.087-0.410). The false positive rate with gesture recognition turned on was 86.1% higher than the false positive rate without gesture recognition which was 79.5%. The diagnostic OR based on the temporal setting of the physical space of the ward was the largest at 3.517(95% CI 1.213-10.193). Conclusions:The intelligent hand hygiene system exhibits high accuracy in monitoring hand hygiene timing. Adjusting the bed sensing range and individualizing the timing settings according to the physical space of the ward can improve the accuracy. Further optimization is needed for posture recognition to improve the accuracy.