Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Objective To search,evaluate and integrate the evidence on enteral nutrition management based on intra-abdominal pressure(IAP)in ICU patients so as to provide an evidence-based basis for a standardised clinical enteral nutrition management for ICU patients with abdominal hypertension.Methods According to the"6S"model,the systematic searches were conducted on CNKI,VIP,SinoMed,Wanfang,Cochrane Library,Medive,UpToDate,International Guidelines Collaboration,Scottish Intercollegiate Guidelines,PubMed,Ovid,Web of Science,Embase,NICE,American Society for Parenteral Enteral Nutrition,World Association for Parenteral Syndromes,European Society of Critical Care,European Society of Clinical Nutrition and Metabolism on the grading of enteral nutrition based on intra-abdominal pressure classification,including guidelines,clinical decision-making,expert consensus,systematic evaluations,summaries of evidence,and original studies closely related to the topic of this study,with a search timeframe up to 31st October 2023.Evidence was extracted and synthesised from the literature that met the quality criteria,taking into account clinical professional judgement.Results A total of 23 articles were retrieved,including four guidelines,one evidence summary,one systematic evaluation,four expert consensuses,six randomized controlled trials,one case-control study and six quasi-experimental studies.Through strict quality evaluation,evidence extraction and summarisation,seven themes with 28 pieces of best evidence were extracted,with IAP grading as the main topic.The themes included definition and grading of abdominal hypertension,IAP monitoring,assessment of target feeding volume,IAP grades I-IV.Conclusion This study summarises the best evidence on graded enteral nutrition management for ICU patients based on IAP.This evidence provides an effective scientific basis on clinical decision-making for ICU professionals.It aims to manage the enteral nutrition for ICU patients with intra-abdominal hypertension using a scientific nursing method,thereby improving the quality of nursing care.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

Objective To search,evaluate and integrate the evidence on enteral nutrition management based on intra-abdominal pressure(IAP)in ICU patients so as to provide an evidence-based basis for a standardised clinical enteral nutrition management for ICU patients with abdominal hypertension.Methods According to the"6S"model,the systematic searches were conducted on CNKI,VIP,SinoMed,Wanfang,Cochrane Library,Medive,UpToDate,International Guidelines Collaboration,Scottish Intercollegiate Guidelines,PubMed,Ovid,Web of Science,Embase,NICE,American Society for Parenteral Enteral Nutrition,World Association for Parenteral Syndromes,European Society of Critical Care,European Society of Clinical Nutrition and Metabolism on the grading of enteral nutrition based on intra-abdominal pressure classification,including guidelines,clinical decision-making,expert consensus,systematic evaluations,summaries of evidence,and original studies closely related to the topic of this study,with a search timeframe up to 31st October 2023.Evidence was extracted and synthesised from the literature that met the quality criteria,taking into account clinical professional judgement.Results A total of 23 articles were retrieved,including four guidelines,one evidence summary,one systematic evaluation,four expert consensuses,six randomized controlled trials,one case-control study and six quasi-experimental studies.Through strict quality evaluation,evidence extraction and summarisation,seven themes with 28 pieces of best evidence were extracted,with IAP grading as the main topic.The themes included definition and grading of abdominal hypertension,IAP monitoring,assessment of target feeding volume,IAP grades I-IV.Conclusion This study summarises the best evidence on graded enteral nutrition management for ICU patients based on IAP.This evidence provides an effective scientific basis on clinical decision-making for ICU professionals.It aims to manage the enteral nutrition for ICU patients with intra-abdominal hypertension using a scientific nursing method,thereby improving the quality of nursing care.

Objective To carry out a joint simulation exercise of tabletop deduction for the staff performing overseas medical services on hospital ships,so as to improve the infection prevention and control.Methods Sixty mission members were selected by convenience sampling to carry out joint simulation drills for tabletop deduction.The effects of the drills were assessed by the survey on the satisfaction and participation of mission members,before-and-after control study,and mission execution.Results Overseas medical service tasks were successfully completed through the desktop-propelled joint simulation drills.The total score of response for infectious emergencies,prevention score,preparedness score,and rescue score after training were higher than those before training(P<0.05).There were high degrees of participation and satisfaction in the drills(≥4.5 points).Conclusion The tabletop deduction and simulation exercise achieve good results in the infection prevention and control of hospital ships.The scheme of tabletop deduction combined with simulation drills will be optimized to continuously improve the infection prevention and control of hospital ships.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

Objective:To construct the enteral nutrition nursing scheme of ICU patients with abdominal hypertension based on internal abdominal pressure classification, and provide reference for effectively preventing enteral nutrition intolerance of ICU patients with abdominal hypertension.Methods:According to the "6S" evidence pyramid model, searched from top to bottom for relevant literature on enteral nutrition support for ICU patients with abdominal hypertension in databases such as BMJ Best Practice, Cochrane Library, Guidelines International Network, Medlive, UpToDate, PubMed, Ovid, Web of Science, Embase, China National Knowledge Infrastructure, VIP, Wanfang Medicine, Chinese Biomedical Literature. Developed an enteral nutrition care plan for ICU patients with abdominal hypertension based on intra-abdominal pressure grading, with a search date from database establishment to January 25, 2023. The Delphi expert letter consultation method was used to conduct two rounds of letter consultation with 20 experts to solicit expert opinions and determine the intervention plan.Results:The age of 20 experts was (43.75 ± 5.28) years old, with a working experience of (22.00 ± 6.98) years. The effective recovery rates of the two rounds of Delphi expert correspondence questionnaires were 100%(20/20), the expert judgment basis coefficients were 0.945 and 0.970, the familiarity coefficients were 0.865 and 0.895, and the authority coefficients were 0.905 and 0.932, respectively. Kendall coordination coefficient of importance of the first, second and third level items in the two rounds of expert correspondence were 0.100, 0.093, 0.098 and 0.200, 0.165, 0.119. The Kendall coordination coefficients of operability for the first, second and third level items were 0.117, 0.130, 0.115 and 0.200, 0.184, 0.154, respectively. Finally, an enteral nutrition nursing scheme for patients with abdominal hypertension in ICU was formed, which included 5 primary items, 30 secondary items and 51 tertiary items.Conclusions:The Delphi method in this study has a high degree of authority and enthusiasm of experts, and a good degree of coordination of expert opinions. The established enteral nutrition nursing scheme for ICU patients with abdominal hypertension based on intra-abdominal pressure classification is reliable and scientific, and can provide reference for clinical nursing practice of enteral nutrition for ICU patients with abdominal hypertension.

Objective To explore the characteristic elements of post competence of nursing staff in large surface ships medical support,and to provide reference for the special training within military hospital and training for dispatched nursing staff.Methods Sixteen medical people who have carried out the large surface ship medical support were selected as research objects using the purposive sampling method.One-to-one semi-structured interviews were performed.The Colaizzi phenomenological analysis was used to carefully sort out and analyze the obtained data and summarize the theme.Results The core competency characteristics of nursing staff during the large surface ships medical support were extracted,including four elements:professional knowledge of common diseases on ships,professional nursing skills on ships,rescue professional ability in ships,and military quality.Conclusion It is essential to construct nursing staff training,system based on the core competencies of large surface ships medical support,and to reserve military nursing talents in daily training,so as to complete medical support tasks with high standards.

This paper introduces the airway care of a patient with motor neuron disease treated with mechanical ventilation for eight years. The airway care for the patient focused on individualized suctioning,measures to prevent atelectasis such as lung hyperinflation,adjustments of ventilator parameters,regular weaning exercise,as well as measures to prevent ventilator-associated pneumonia such as prevention of aspiration,strict disinfection and isolation,wound care of tracheotomy. The ventilator-associated pneumonia was effectively prevented. Effective nursing care for patients with long-term mechanical ventilation can prevent atelectasis and ventilator-associated pneumonia.