An introduction to the Basic service module featuring holistic,full flow and seamless connection built by the hospital.Authors described their experiences in achieving homogenous clinical nursing care,and pointed out that integrating medical humanistic care into the daily nursing process,can improve doctor-patient relationship and patients satisfaction,thus raising medical service quality and efficiency.

Objective To investigate the effect of quality control circle on reducing incidence of fecal incontinence dermatitis of intensive care unit (ICU) patients. Methods Quality control circle team was set up and theme was determined then retrospective analysis was carried out for the occurrence of defect in patients with fecal incontinence dermatitis from January to May 2014 before quality control circle activities. Occurrence reasons were explored and corrective measures were formulated and implemented.After the implementation of quality control circle,the occurrence of defect from June to October 2014 was observed. Results After the implementation of quality control circle,the occurrence of fecal incontinence dermatitis reduced from 24.5%(24/98) to 10.4% (10/96) and the difference was statistically significant,χ2=6.65, P<0.05. Conclusion Quality control circle is effective for reducing the occurrence of ICU fecal incontinence dermatitis and continual improvement of nursing quality.

Objective To investigate the curative effect of bronchoalveolar lavage with fiberoptic bronchoscopy combined with vibration sputum drainage in the treatment of severe pneumonia patients undergoing mechanical ventilation (MV).Methods A prospective randomized controlled trial was conducted. 286 severe pneumonia patients undergoing MV admitted to intensive care unit (ICU) of Hunan People's Hospital from January 2014 to July 2016 were enrolled, and they were divided into control group and observation group according to random number table, with 143 patients in each group. Patients in both groups received sensitive antibiotics for anti-infection, etiological treatment, and calefacient and humidifying treatment. The patients in the control group received bronchoalveolar lavage with fiberoptic bronchoscopy, and those in the observation group received bronchoalveolar lavage combined with vibration sputum drainage. The parameters of respiratory function and inflammation before and after treatment, curative effect, and prognosis were compared between the two groups.Results ① There were no significant differences in respiratory function parameters between the two groups before treatment, 2 hours after treatment, the parameters were improved in both groups. Moreover, oxygenation index (PaO2/FiO2) in observation group was significantly higher than that of control group [mmHg (1 mmHg = 0.133 kPa): 379.1±20.2 vs. 351.8±24.7], and arterial partial pressure of carbon dioxide (PaCO2) and airway resistance (Raw) were significantly lower than those of the control group[PaCO2 (mmHg): 36.5±5.8 vs. 45.3±6.9, Raw (cmH2O, 1 cmH2O = 0.098 kPa): 12.9±0.6 vs. 13.1±0.8, allP < 0.01]. ② There were no significant differences in inflammation parameters between the two groups before treatment, 24 hours after intervention, which were significantly decreased in both groups. Moreover, white blood cell count (WBC), procalcitonin (PCT) and C-reactive protein (CRP) in the observation group were significantly lower than those of the control group [WBC (×109/L): 8.2±1.7 vs. 12.8±3.7, PCT (μg/L): 15.4±2.4 vs. 21.8±3.1, CRP (mg/L): 37.1±6.1 vs. 67.2±7.2, allP < 0.01]. ③ Compared with the control group, the treatment efficiency of observation group was improved [95.1% (136/143) vs. 87.4% (125/143)], the quantity of sputum excretion was increased (mL: 49.2±12.5 vs. 36.9±11.0), duration of MV and length of ICU stay were significantly shortened (days: 6.4±3.6 vs. 9.4±2.1, 8.6±5.7 vs. 12.4±4.6, bothP < 0.01), however, there was no significantly statistical difference in 28-day mortality between control group and observation group [2.8% (4/143) vs. 2.1% (3/143),P > 0.05].Conclusion Compared with bronchoalveolar lavage with fiberoptic bronchoscopy alone, the treatment of bronchoalveolar lavage combined with vibration sputum drainage is more effective in sputum excretion for severe pneumonia patients undergoing MV, which could improve the respiratory function, reduce infection, shorten the duration of MV and the length of ICU stay, and improve the recovery.

Objective To evaluate the effects of Massive Open Online Course (MOOC) on standardized training of nurses.Methods The 148 new nurses from August 2015 to July 2016 were selected as the control group, and trained in traditional teaching mode. The 150 new nurses from August 2016 to July 2017 were recruited as the observation group, and trained with MOOC on the basis of traditional teaching mode. The scores of core ability, including the theoretical and operational assessment, critical thinking and clinical nursing were compared between the two groups.Results After one year of training, the scores of theoretical and operational assessment of the observation group were (97.16±1.92) and (96.56±1.87) respectively, which were better than those of the control group, and the difference were statistically significant (t=12.091, 7.895;P<0.001). The scores critical thinking / academic research ability and clinical nursing ability of the observation group were (25.66±5.12) and (25.12±4.42) respectively, which were better than the control group, and the differences were statistically significant (t=2.191, 2.030;P<0.05).Conclusions The application of MOCC with traditional teaching mode on the new nurse standardized training is helpful to improve new nurses' theoretical and operational knowledge, enhance the satisfaction of clinical departments, and to cultivate new nurses critical thinking, ethical practice and other core competencies.

? Frailty is a multidimensional syndrome, reflecting the decline of the body's physiological reserve. The patients are often accompanied by a variety of diseases. The postoperative complications and mortality were significantly increased on frail patients due to improper anesthesia and perioperative management. Enhanced recovery after surgery optimizes perioperative treatment and achieves rapid recovery compared with traditional measures. However, perioperative management of patients with frailty is still in the exploratory stage. Common assessment methods for weakness are the debilitating phenotype and the debilitating index. This article focuses on the perioperative related problems of debilitated patients (low nutritional status, poor mental condition, complicated condition and many complications, multi-disciplinary collaboration, prone to fall and fall), and provide the basis for the frailty management of elderly medical workers.

Objective? To evaluate the status and influencing factors of frailty among elderly people aged 60 or above in a remote area in Hu＇nan Province and to provide evidence for preventing frailty among the elderly people in remotely rural areas. Methods? Totally 101 elderly people aged≥ 60 were selected from Shizhu Village, Dongkou County, Shaoyang City, Hu＇nan Province using convenient sampling between July and September 2018. The elderly people＇s demographic indicators, complications, smoking and drinking history, physical exercise and sleep quality were collected. Vulnerable Elders Survey (VES-13) was used to evaluate the frailty among elderly people, and Logistic regression analysis was employed to analyze and screen the risk factors of frailty. Results? Totally 39 out of the 101 (38.6%) elders showed frailty. Univariate analysis showed that there was statistically significant difference in frailty between elders with different age, mode of living, number of complications and physical exercise (P＜ 0.05). According to Logistic regression analysis, the independent risk factors of frailty among the elders aged 60 or above in remote areas included aged 70-79 (OR=8.406,95%CI: 2.381-29.684,P=0.001), aged 80-89 (OR=14.087,95%CI: 2.372-83.673,P=0.004), number of complications≥ 3 (OR=8.458,95%CI: 1.307-54.754,P=0.025), and lack of physical exercise (OR=12.448,95%CI: 3.165-48.961,P＜ 0.001). Conclusions? Frailty is common in the elders in remote areas, which is associated with venerable age, multiple complications and lack of physical exercise. Therefore, we should pay attention to the frailty among the elders in remote areas and provide intervention accordingly.

Objective To explore the effects of nurse-patient horizontal communication on medical compliance behavior and postoperative complications in patients with benign prostatic hyperplasia ( BPH ) . Methods A total of 218 patients with BPH were recruited in the department of urology of Hunan Provincial People′s Hospital from March 2014 to December 2015. They were divided into control group ( n=109, routine nursing) and experimental group ( n=109, routine nursing+personalized horizontal communication model ) according to the order of admission. After intervention, patient compliance, the length of hospital stay, postoperative complications and patient satisfaction were evaluated between two groups. Results The patient compliance behavior on medication, reasonable diet and relaxation, giving up smoking and drinking of patients in experimental group were better than those in control group. Besides, the length of hospital stay and the number of patients with gross hematuria, enuresis or lower urinary tract symptoms in experimental group were less than those in control group. Moreover, the patient satisfaction of experimental group was better than that of control group. There were significant differences in those aspects between two groups ( P < 0. 05 ) . Conclusions The nurse-patient horizontal communication will be propitious to improve the patient compliance, reduce the length of hospital stay, decrease the incidence of complications and increase the patient satisfaction.

Objective To investigate the application and effects of navigation guidance in the diagnosis and treatment of patients so as to standardize the process of medical activities,provide convenience for patients and improve the quality of clinical service. Methods A total of 582 patients from outpatient clinic,306 hospitalized patients with MRI examinations and 124 medical staff from May 2015 to June 2015 in Hu'nan People's Hospital were randomly selected as control group. A number of 582 patients from outpatient clinic,306 hospitalized patients with MRI examinations and 124 medical staff from July 2015 to August 2015 were randomly selected as experimental group. Patients in control group went for waiting doctor,treatment,examination and taking medicine with the guidance of responsible nurses. Patients in experimental group were guided with additional navigation guidance which was designed depend on the hospital. Treatment time of patients from outpatient clinic,MRI examination time of hospitalized patients,satisfaction of patients and medical staff to treatment time,treatment procedure and clinical service were compared between two groups. Results After the usage of navigation guidance,treatment time of patients from outpatient clinic in experimental group (63.53±32.97) was shorter than that in control group (67.94±39.44). The difference was statistically significant (P < 0.05). MRI examination time of hospitalized patients in experimental group (30.90±12.19) was shorter than that in control group (33.75±13.38), with significant difference (P<0.05). Satisfaction rates of patients to waiting time,treatment procedure and clinical service in experimental group were higher than those in control group (t=-3.977,-3.355,-4.843,P<0.001). Average satisfaction rate of medical staff to treatment procedure in experimental group (84.26±9.80)% was significant higher than that in control group (80.27±9.40)% (P<0.05). Conclusions Application of navigation guidance improves the standardization and specification of diagnosis and treatment procedure and clinical service levels. It is an effective management method which could significantly short patients' treatment and examination time so as to promote the satisfaction rate of medical staff and patients.

Objective To formulate a comprehensive and reasonable admission nursing assessment sheet with specialty features, so as to improve quality of nursing assessment for patients at admission to Department of Hepatobiliary Surgery. Methods According to characteristics of patients newly admitted to Department of Hepatobiliary Surgery and need of medical service,a nursing assessment sheet suitable for inpatients to Department of Hepatobiliary Surgery was designed,with main contents including basic information, physical examinations for nursing,conditions of daily life,social and psychological conditions,specialty examinations,risk of falling down from bed,and risk of pressure sores. Incidence rate of adverse nursing events like patients' falling down from bed or pressure sores,and the patients' satisfaction were compared before (June 2014 to May 2015) and after (June 2015 to May 2016) application of this sheet. Results After application of this new version of admission nursing assessment sheet,incidence of adverse nursing events happened to inpatients dropped from 2.95% to 0.91% (χ2=4.386,P< 0.05);patients' satisfaction increased from (83.16±10.62) to (90.41±8.66) (t=14.103,P<0.05). Conclusions By using this new version of admission nursing assessment sheet,status of the patients can be assessed in a diversified and multi-dimensional way,so that incidence of falling down from the bed can be lowered,medical risks be decreases,patients' satisfaction be increased,and nursing efficiency be improved,which make it worth promoting in Department of Hepatobiliary Surgery.

Objective To establish a standardized training and assessment system for new nurses in the internet age and investigate the application effect of the system on the standardized training of new nurses. Methods From March 2015 to March 2017, a standardized training program was formulated based on national training program for new nurses. Nursing training massive open online courses (MOOC) were constructed in the cooperation with software company. A scientific and efficient system for the management, training and assessment of new nurses was established depended on nursing management system and educational network platform. A number of 97 nurses recruited in 2014 were served as control group and trained with traditional training methods between March 2015 and March 2016. Another 96 nurses recruited in 2015 were acted as observation group and treated with standardized training based on the new system in the internet age between March 2016 and March 2017. The training and assessment effects of new nurses were compared between two groups. Results The perfect rate of personal information and participation rate of training of nurses in the observation group were 97.83% and 100.00%, which were significantly higher than those in the control group (χ2=7.158, 7.034;P<0.01). The training time of nurses in the observation group was (21.45±2.87) h,which was shorter than the control group's (35.12±3.75) h (t=28.479, P<0.01). The excellent and good rates for the theoretical exam of new nurses in the observation group were 17.39% and 56.52% and the excellent and good rates for operation examination and clinical practice ability examination of new nurses in observation group were 11.96% and 69.56%, which were significantly higher than those of the control group (Z=-3.736, -4.000;P<0.01). The satisfaction rate of new nurses to the training and assessment in the observation group was 97.82%, which was higher than that of the control group (82.47%). The difference was statistically significant (χ2=14.808, P<0.01). Conclusions The standardized training and assessment system using MOOC for new nurses in the internet age could improve the effectiveness of standardized training and satisfaction for new nurses, which is beneficial to the improvement of the nursing training quality and management benefit.