Objective To construct a knowledge graph of healthcare-associated infection(HAI)prevention and control course,and evaluate its usability.Methods Based on the constructivist learning theory and the analyze-de-sign-develop-implement-evaluate(ADDIE)model,knowledge from various sources such as books,guidelines,and literature related to HAI prevention and control were integrated.The knowledge graph of HAI prevention and con-trol course were designed and constructed with the support of knowledge graph technology in Chaoxing Fanya plat-form.Thirty medical students were selected by convenience sampling method to try out the course knowledge graph.System usability scale and usage effect questionnaire were filled out to evaluate the usability of the knowledge graph.Results The knowledge graph of HAI prevention and control course contained 379 knowledge points asso-ciated with 520 test questions and 56 learning resources.After testing,the total score([70.50±12.20]points)was obtained for the usability of the knowledge graph.Among the four dimensions of the usage effect agreement ques-tionnaire,satisfaction,learning attitude,learning ability,and learning resource support accounted for 93.33％-96.67％,90.00％,93.33％-96.67％,and 83.33％-90.00％,respectively,with a high overall satisfaction rate.Conclusion The knowledge graph of HAI prevention and control course has good usability,which can realize students'personalized independent learning and improve their learning efficiency.

Objective To explore the current situation of healthcare-associated infection(HAI)in patients in emergency rescue room and observation room,and analyze the causes.Methods Targeted surveillance was per-formed on patients in emergency rescue room and observation room of a tertiary first-class hospital in Xuzhou City from January 1 to December 31,2023 using prospective survey method.HAI,antimicrobial use,as well as invasive procedures and related infection rates were analyzed.Results The incidence of HAI in 540 patients was 0.19％(n=1),and the daily incidence of HAI was 0.54‰(1/1 841).The utilization rates of invasive ventilators,central ve-nous catheters,and indwelling urinary catheters were 6.79％(125/1 841),1.09％(20/1 841),and 2.93％(54/1 841),respectively.The incidences of ventilator-associated pneumonia,central line-associated bloodstream infec-tion,and catheter-associated urinary tract infection were 8.00‰(1/125),0(0/20),and 0(0/54),respectively.Pathogen detection rate before antimicrobial treatment was 99.22％(382/385).Conclusion The incidence of HAI in patients in emergency rescue room and observation room is low,the retention time of patients in rescue room is short,and pathogen detection of specimens before antimicrobial treatment is high.Patients in emergency rescue room and observation room are at high risk of HAI.It is necessary to carry out targeted surveillance on HAI to re-duce its incidence.

Objective To systematically evaluate the current status of quality of life in infertile patients and its influencing factors.Methods Computer search of PubMed,Cochrane Library,Web of Science,Embase,CBM,Knowledge Network,Wanfang,and Wipu,with a search timeframe from the establishment of the library to December 2023,and meta-analysis using CMA 3.3 software.Results A total of 33 literatures were included in the current status of quality of life,which showed that the level of quality of life was 60.841[95％CI(58.029,63.654),P＜0.001]for the FertiQoL scale and 67.630[95％CI(59.541,75.718),P＜0.001]for the SF-36 scale.A total of 45 papers were included in the literature on factors influencing quality of life,and the results showed that personal trait factors of young age(r=0.181,P=0.006)and history of pregnancy(r=0.258,P＜0.001)were lowly positively correlated with quality of life,and that long years of infertility(r=-0.267,P＜0.001),a history of treatment failure(r=-0.292,P＜0.001),and long duration of treatment(r=-0.213,P＜0.001)had a low negative association with quality of life.Behavioural factors such as anxiety(r=-0.547,P＜0.001),depression(r=-0.556,P＜0.001),and stigma(r=-0.530,P＜0.001)were highly negatively correlated with the quality of life;high fertility stress(r=-0.333,P=0.010)was moderately negatively correlated with the quality of life;and good psychological resilience(r=0.383,P＜0.001)and high self-esteem(r=0.343,P=0.001)were moderately positively associated with quality of life.Interpersonal network factors of good relationship with husband(r=0.337,P＜0.001)were moderately positively correlated with quality of life,and having a reproductive history(r=0.124,P＜0.001)was lowly positively correlated with quality of life.Good occupation(r=0.149,P=0.002)was low positively associated with quality of life among the factors of work and living conditions;high annual household income(r=0.307,P＜0.001)was moderately positively associated with quality of life.Having health insurance in the policy environment(r=0.131,P＜0.001)was low positively associated with quality of life.Conclusion The level of quality of life of infertile patients is impaired to some extent and there are many influencing factors,so healthcare professionals should comprehensively assess the quality of life of patients and adopt targeted and personalised interventions to improve the quality of life of patients.

Objective:To understand the post-traumatic growth status and related factors of patients with liver cancer undergoing interventional therapy.Methods:A total of 160 patients with liver cancer receiving interventional therapy in a third-class first-class hospital in Xuzhou were assessed using the Self-designed General Information Questionnaire,Post Traumatic Growth Inventory(PTGI),Medical Coping Modes Questionnaire(MCMQ)and Quality of Life for Liver Cancer(QOL-LC).Results:The PTGI total score was(53.8±10.1).Multiple regression analysis showed that the average monthly family income(β=0.11),face-to-face scores(β=0.28)and the total QOL-LC scores(β=0.16)were positively correlated with the PTGI scores,whereas advanced disease stages(β=-0.14),number of interventional therapy sessions(β=-0.06)and avoidance scores(β=-0.27)were negative-ly correlated with PTGI scores.Conclusion:The post-traumatic growth of patients with liver cancer treated by inter-ventional therapy is at a moderate-to-low level.Post-traumatic growth is related to family income per capita,disease stages,times of interventional therapy,medical coping style and quality of life.

Objective To understand the application of healthcare-associated infection(HAI)quality control indi-cators and current status of HAI management in primary medical institutions in Jiangsu Province,and provide refe-rence and basis for primary medical institutions to improve HAI management quality and for health administrative departments to formulate HAI management relevant policies.Methods Data on HAI quality control indicators co-llected by Jiangsu Provincial Primary Healthcare Professional Quality Control Center from the first batch of 62 pri-mary sentinel medical institutions in the province were analyzed.Results of on-site inspections and assessments of 20 institutions were summarized and analyzed.Results From July 2023 to May 2024,a total of 145 814 inpatients were monitored,219 patients had 220 episodes of HAI.The incidence and case incidence of HAI were both 0.15％,and the main HAI site was upper respiratory tract(40.45％).The compliance rate and correct rate of hand hygiene were 81.34％(14.29％-100％)and 87.90％(18.46％-100％),respectively.The removal rate of surface pollu-tant from environmental objects was 77.24％(20.00％-100％),and the qualified rate of cleaning of device,appli-ances,and articles was 98.76％(10.00％-100％).The monitoring data records of quality control indicators in most primary healthcare institutions during on-site inspections didn't match the monthly data reported to the Jiangsu Provincial Primary Healthcare Professional Quality Control Center.Most healthcare workers in primary healthcare institutions lacked sufficient awareness and knowledge in infection prevention and control.Multiple HAI-related safety hazards existed in key departments of most primary medical institutions.Conclusion After nearly a year of continuous monitoring on HAI,the primary sentinel medical institutions have established their own data on the inci-dence of HAI.The compliance rate and correct rate of hand hygiene,as well as the removal rate of surface pollu-tants from environmental objects are still relatively low in some medical medical institutions,and there is much room for improvement.There is still a significant gap in terms of HAI prevention and control in some primary medical in-stitutions when referring to the standards.

Objective:To develop a training curriculum targeting the core competences of neurosurgery nurses, so as to provide a reference for standardized training of neurosurgery nurses and to strengthen their professionality.Methods:Centering on the core competences required for neurosurgery nurses, we formed the curriculum framework based on the cell structure-inspired concept proposed by the School of Nursing of The Hong Kong Polytechnic University, and determined the contents through a literature analysis and two rounds of questionnaire-based Delphi consultations with 16 experts. We increased, reduced, or modified the items and dimensions, and finally estabilished the curriculum for neurosurgery nurse training. SPSS 18.0 software was used to analyze the general information of experts, coordination coefficient, variation coefficient, full mark ratio, and mean importance value. Categorical data were described as frequencies and percentages, and continuous data were described as mean±standard deviation. Ranked data were analyzed by using the chi-square test.Results:In the two rounds of expert consultations, questionnaires were both 100.00% returned, and the coefficients of expert authority were 0.873 and 0.888, respectively. The coordination coefficient of curriculum modules and curriculum contents were 0.416 and 0.221, respectively ( P<0.001). For individual items across the curriculum modules, the mean importance value was 3.188-3.938, the variation coefficient was 0.063-0.178, and the full mark ratio was 0.250-0.875. For content items, the mean importance value was 3.250-4.000, the variation coefficient was 0-0.238, and the full mark ratio was 0.375-1.000. The established clinical practice-directed curriculum for neurosurgery nursing training included 6 course modules (anatomy and physiology of the nervous system, neurosurgery patient evaluation and monitoring, neurosurgery disease nursing, commonly used neurosurgery nursing techniques, nursing management, and scientific research basis) and 77 content items. Conclusions:The established training curriculum targeting the core competences for neurosurgery nurses is reliable, which can provide a reference for standardized training of neurosurgery nurses.

0bjective:To explore the responsiveness and minimal clinical significance difference(MCID)of the Chinese version of the Chelsea critical care physical assessment tool(CPAx),the Perme Score intensive care unit mobil-ity score(Perme Score),and the intensive care unit(ICU)mobility scale(IMS)for patients in ICU during the early-stage rehabilitation,providing more comprehensive evidence support for clinical application of these scales.Method:It is a prospective observational study.The convenience sampling method was used to select 114 pa-tients in a ICU of a Tertiary Hospital in Shanghai from March 2021 to December 2021.Patients were as-sessed by Chinese version of CPAx,Perme Score,and IMS before the first rehabilitation treatment and within 24 hours before discharge from ICU.Likert five-scale was used to evaluate the overall changes in health sta-tus of the patients after the last rehabilitation.Responsiveness includes both internal responsiveness and exter-nal responsiveness.Internal responsiveness was determined by pair t-test,effect size(ES)and standardized re-sponse mean(SRM);external responsiveness was assessed by using Spearman correlation coefficient.MCID was calculated by integrating the estimates from the distribution-based methods and the anchor-based methods.Result:Internal responsiveness outcomes indicated that there was significant difference between the score of CPAx,Perme Score and IMS before and after rehabilitation(P＜0.05),with ES of 1.03,1.09 and 1.14,and SRM of 1.75,1.52 and 1.73,respectively.The results showed that the scale had good internal responsiveness and could sensitively reflect the changes of patients'condition.External responsiveness outcoms showed that Spearman correlation coefficients of CPAx,Perme Score and IMS with global rating of change(GRC)were 0.67,0.50 and 0.30,respectively(P＜0.01),indicating that apart from IMS,the other scales had good external reactivity,and could reflect the changes of patients'self-perception during the rehabilitation process.The MC-ID of CPAx scale with ES as the intermediate index is 5.66,SEM is 5.48,self-therapeutic effects is 8.73.The MCID of Perme Score with ES is 2.43,SEM is 3.64,self-therapeutic effects is 5.00.The MCID of IMS scale with ES is 1.28,SEM is 2.01,self-therapeutic effects is 2.43.Conclusion:Except for the lack of external responsiveness of IMS,the other Chinese version scales had good internal and external responsiveness in early-stage rehabilitation of ICU patients.Combined with the litera-ture review and the actual situation of using the scale in the study,the mean values of distribution method and criterion method were taken to preliminarily determine that the MCID of Chinese version of CPAx,Perme Score and IMS in ICU early rehabilitation were 6.62,3.69 and 1.90,respectively.

Objective To explore the different potential subtypes of psychosocial adaptation among young and middle-aged stroke patients,and analyze the relationship between different potential subtypes and quality of life,so as to provide references for the subsequent development of targeted interventions.Methods A total of 406 young and middle-aged stroke patients in 4 tertiary hospitals in Suzhou from June 2023 to June 2024 were recruited by convenience sampling.The General Information Questionnaire,the Self-Report Psychosocial Adjustment to Illness Scale and the EuroQol five-dimensional questionnaire were conducted for investigation.Latent profile analysis was used to explore the potential subtypes of psychosocial adaptation among young and middle-aged stroke patients.Generalized linear regression analysis was conducted with quality of life as dependent variables.Results A total of 380 young and middle-aged stroke patients were included.The psychosocial adaptation of patients could be classified into 3 potential subtypes:high adaptation level type(23.90％),medium adaptation level with health concerns type(46.40％),and low adaptation level with psychological barriers type(29.70％).The results of generalized linear regression analysis showed that potential subtypes of psychosocial adaptation were the influencing factors for quality of life in young and middle-aged stroke patients(P＜0.05).Conclusion There was group heterogeneity in psychosocial adaptation among young and middle-aged stroke patients,and the potential subtype of psychosocial adaption was an important factor affecting the quality of life of patients.It is suggested that medical staff should focus on patients with low adaptation level with psychological barriers type,and take targeted interventions according to characteristics of different subtypes of patients,so as to improve their quality of life.

Objective To construct a classification model for surgical patients and apply it in the allocation of nursing human resources,providing a reference for nursing human resource management.Methods A convenience sampling method was used to retrospectively select 5,431 hospitalized surgical patients admitted to 6 surgical nursing units of a tertiary general hospital in Suzhou from July to November 2022 as the subjects of this study.The nursing hours were measured,and related influencing factors were analyzed.A decision tree classification method was used to establish a classification model for surgical patients.From August to October 2022,1,527 hospitalized surgical patients admitted to 3 nursing units of the same hospital were conveniently selected.The minimum number of nurses required daily was calculated using the surgical patient classification model,actual nursing hours measurement method,nurse-to-bed ratio method,and 8-hour continuous shift scheduling method.The application effect of the surgical patient classification model in nursing human resource allocation was evaluated with the actual nursing hours measurement method as the standard.Results The surgical patient classification model includes 7 classification indicators:length of hospital stay,diagnosis-related group weight,presence or absence of secondary care orders,surgical grade,anesthesia method,age,and presence or absence of critical illness orders.Patients were divided into 14 groups,and the model explained 90.5％of the total variance in nursing workload.The minimum number of nurses required in surgical nursing units calculated based on this model was closest to the result of the actual nursing hours measurement method and was superior to the results of the nurse-to-bed ratio method and the 8-hour continuous shift scheduling method.Conclusion The surgical patient classification model can accurately reflect the nursing workload of such patients.The classification indicators are simple and easy to obtain,and can guide the allocation of human resources in surgical nursing units.

Objective:To analyze the relevant studies on fertility concerns intervention programs for breast cancer survivors of childbearing age, and identify the specific content, outcome indicators and intervention effects of intervention, in order to provide reference for clinical staff to implement relevant intervention.Methods:According to the research method of scope review, the studies on the fertility concerns with breast cancer patients of childbearing age in China National Knowledge Infrastructure, WanFang, VIP, China Biomedical Literature Database, CINAHL, PubMed, Cochrane Library, Web of Science etc. were searched. The search period was from database establishment to May 9, 2024. The included literature was classified and analyzed.Results:A total of 12 articles were included, 9 were randomized controlled trials, 2 were self-controlled before and after studies, and 1 was a prospective cohort study. Fertility concerns intervention programs included group fertility counseling centered on couples, fertility support based on a multidisciplinary team collaboration model, and fertility management based on "Internet + reproductive health". The duration of intervention was usually 4 or 24 weeks. The intervention had different effects on the level of fertility concerns, psychological state and marital status.Conclusions:At present, the intervention programs for fertility concerns of breast cancer survivors of childbearing age reflect the importance, professionalism, immediacy and interactivity, but China is in the initial stage, and there are still shortcomings in multidisciplinary teams, fertility referral system, and Internet platform construction. Future research should build a breast cancer fertility intervention program suitable for our country, and promote its application through the Internet.