Objective:To explore and construct the nursing quality standards of spine surgery, provide a scientific basis for improving the nursing quality of spine surgery.Methods:Taking the "structure-process-outcome" three-dimensional quality model as the theoretical framework, through evidenced-based literature search and semi-structured interview, the items pool was formed, and finally the nursing quality standards were determined by two rounds of Delphi method of expert inquiry from May to July 2023.Results:The positive coefficients of the two rounds of inquiries to experts were 0.90 and 1.00, respectively. The authority coefficients were 0.946 and 0.951, respectively. The Kendall coefficients of the first, second and third level standards in the first round were 0.161, 0.095 and 0.108, respectively, and the Kendall coefficients of the first, second and third level standards in the second round were 0.162, 0.088 and 0.100, respectively, the differences were statistically significant (all P<0.05). The final nursing quality standards were finally constructed, including 3 first-level standards (structural quality, process quality and outcome quality), 20 second-level standards and 60 third-level standards.Conclusions:The nursing quality standards of spine surgery based on the three-dimensional quality model of "structure-process-outcome" have high reliability and science, which can provide target incentives for clinical nurses, provide a basis for the quality of specialized spine nursing, and promote the development of nursing specialization and the construction of nursing discipline.

Objective:To explore the effectiveness of applying the ADDIE (analysis, design, develop, implement, evaluate) Model in clinical teaching for nursing interns in spine surgery department.Methods:Using a convenience sampling method, 44 nursing interns in the Department of Orthopedics at Peking Union Medical College Hospital were selected as the control group from July 2021 to May 2022, and were taught using traditional methods. From July 2022 to May 2023, 45 nursing interns were selected as the observation group, and a teaching team was formed to design a training program based on the five stages of the ADDIE instructional design model. This program was tailored to improve the overall clinical competence of the spinal surgery nursing interns. After training, the teaching effects were evaluated based on knowledge test scores, skills test scores, overall clinical competence, and teaching satisfaction.Results:After the training, the skills test scores in specialized nursing for the observation group were (94.87±1.10) points, higher than the control group's (93.98±1.41) points, with a statistically significant difference ( P<0.01). The observation group also scored higher than the control group in clinical judgment, organizational effectiveness, overall performance, and total score in the Mini-Clinical Evaluation Exercise, with statistically significant differences ( P<0.01). Additionally, the observation group reported higher satisfaction with the teaching plan and methods compared to the control group ( P<0.05) . Conclusions:Clinical teaching for spinal surgery nursing interns based on the ADDIE instructional design model can improve their specialized practical skills and overall clinical competence. The interns also expressed a high level of acceptance for this teaching design model.

Early-onset scoliosis(EOS) refers to scoliosis diagnosed under 10 years old, and early intervention should be carried out for progressive EOS. Surgery is one of the main treatments. Due to the physiological and psychological characteristics of children such as organ structure and function are still in the stage of growth and development, young age and poor compliance, perioperative nursing strategies are different from adults, this article focuses on 13 aspects, including admission and preoperative assessment, safety management, vital signs observation, neurological function monitoring, fluid and electrolyte balance, general anesthesia awakening delirium, pain management, nutrition management, tubing management, position and early mobilization, surgical site infection prevention, identification and treatment of hemopneumothorax, and discharge-related nursing.

Objective:To explore the occurrence and influencing factors of paralytic ileus (PI) in patients with adolescent idiopathic scoliosis (AIS), so as to provide references and basis for the formulation of clinical nursing intervention measures.Methods:Using the convenient sampling method, a total of 93 AIS patients who were hospitalized in Spine Center of Peking Union Medical College Hospital from January 2019 to June 2020 were selected as the research objects. The general information, disease and operation related information of patients were collected, and the incidence of PI was recorded. Binomial Logistic regression was used to analyze the influencing factors of PI occurrence in AIS patients after surgery.Results:PI occurred in 41.9% (39/93) patients, and the incidence of anorexia, abdominal distention, nausea, vomiting and abdominal pain were 66.7% (26/39), 61.5% (24/39), 59.0% (23/39), 30.8% (12/39) and 20.5% (8/39), respectively. Binomial Logistic regression analysis showed that straight leg elevation exercise ( OR=3.582, P=0.023), postoperative first feeding time ( OR=1.209, P=0.027), proton pump inhibitors ( OR=6.820, P=0.002) and osteotomy ( OR=5.516, P=0.007) were the influencing factors of PI occurrence after AIS. Conclusions:The incidence of PI is higher in AIS patients after surgery and the accompanying symptoms are mainly anorexia, abdominal distension and nausea. Straight leg elevation exercise, time of first postoperative feeding, proton pump inhibitors and osteotomy are the influencing factors of postoperative PI in AIS patients.

Objective:To construct the core competence indicator system of newly recruited nurses based on the concept of safety and quality improvement, so as to provide a reference for the construction of the training system of the core competence and the formulation of evaluation standards of newly recruited nurses.Methods:Through literature retrieval and analysis, a framework of core competency indicator system of newly recruited nurses guided by the concept of safety and quality improvement was initially constructed. From November 2020 to March 2021, 15 nursing education and nursing practice experts across the country were consulted for 3 rounds through the Delphi expert consultation, and the expert opinions were collected to finally determine the indicator system.Results:Among 3 rounds of expert consultation, the response rates of the questionnaires were all 100%, and the expert authority coefficient was 0.90, and the Kendall coordination coefficient of the three-level indicators was from 0.14 to 0.20 ( P<0.05) . The finalized core competence indicator system of newly recruited nurses included 7 first-level indicators (professional knowledge and ability, patient-centered nursing, cooperative communication, quality promotion, safety, nursing information ability, professional development) , 18 second-level indicators and 103 third-level indicators. Conclusions:The indicators of the core competence indicator system of newly recruited nurses are good, which can provide a reference for optimizing the training courses for newly recruited nurses and improving the evaluation standards.

Objective:To construct a structured 3C dynamic disease observation form for patients undergoing spinal surgery and to explore its application effect in clinical work.Methods:Based on the literature evidence, a structured 3C disease observation form was formed through focus group interviews. Before the application of the form (from June 2018 to August 2018) , the related situations where responsible nurses used a traditional form to prepare information about the patients' conditions were collected 100 times. After the application of the form (from September 2018 to November 2018) , the related situations where responsible nurses used a structured 3C dynamic disease observation form to prepare information about the patients' conditions were collected 100 times. Before and after the application, the nurses' mastery rate of the patients' conditions, the time for the nurses to master the patients' conditions and the nurses' satisfaction with the form were compared.Results:After application of the structured 3C disease observation form, the average rate of nurses' mastery of patients' conditions increased from 88.2% to 95.1%, and the difference was statistically significant (χ 2=39.826, P<0.01) . The time spent for nurses to master the patients' conditions was shortened from (7.61±1.67) min before the implementation to (5.34±1.33) min after the implementation, and the difference was statistically significant ( t=10.654, P<0.01) . The satisfaction score of the nurses on the traditional form was (28.50±2.20) points and the satisfaction score of the structured 3C disease observation form was (35.80±3.15) points, and the difference was statistically significant ( t=-8.097, P<0.01) . Conclusions:The application of structured 3C disease observation form can significantly improve the nurses' mastery rate of patients' conditions, improve work efficiency and increases nurses' satisfaction with their own nursing work, which is helpful to improve the quality of nursing management.

Objective: To summarize the experience of respiratory tract management in a case of spinal muscular atrophy with neuromuscular scoliosis. Methods: Respiratory tract nursing included prevention of pulmonary infection, inspiratory muscle training, rebuilding respiratory form before surgery, and assessment of sputum expectoration capacity, pain management, airway management after surgery. Results: The patient was discharged without pulmonary complications. Conclusions For patient with breathing problem, respiratory tract management can prevent pulmonary complications during perioperative period.

0bjective To summarize the nursing experience of 1 case underwent total hip arthroplasty of left side after 4 years of heart transplantation. Method Effective preoperative assessment and adequate preparation for patients. Prevent the postoperative complications such as cardiac allograft vasculopathy, infection,renal impairment. To conduct effective psychological care. Implementing individualized functional training. Ensuring patient safety. Promoting functional recovery of hip joint in patients. Results After careful nursing care, the patient recovered well and discharged from hospital after 5 days. Conclusions In view of this patient. Adequate preoperative assessment, prevention of complications after surgical and individual functional exercise. All of these could ensure perioperative safety of patients. They have effective means to promote functional recovery of hip joint.

Objective? To explore the cognition of nurses in high-risk surgical departments for prevention of venous thromboembolism (VTE). Methods? Totally 464 nurses in surgical departments at high risk of VTE (departments of orthopedics, general surgery, neurosurgery, thoracic surgery, and critical care medicine) from 11 provinces (municipalities and autonomous regions) nationwide who attended the seminar on nursing by the Chinese Nursing Association in September 2017 were investigated with VTE Prevention Knowledge Questionnaire for Clinical Nurses to understand their knowledge about basic, physical and drug prevention for VTE. Results? The cognition of VTE prevention of nurses in high-risk surgical departments scored (13.51±3.42), standing at a medium level. In particular, the knowledge about physical prevention was unsatisfactory, which scored (5.71±2.18). The cognition score of VTE prevention varied in nurses of different departments, and the cognition of VTE prevention of nurses from departments of general surgery, orthopedics and critical care medicine was relatively better. Multivariate analysis revealed that educational background was an independent risk factor for the cognition of VTE prevention of nurses in high-risk surgical departments (OR=1.630,95%CI:1.035-2.567). Conclusions? The cognition of VTE prevention of nurses in high-risk surgical departments is unsatisfactory and cannot meet the needs of clinical work. Targeted training should be provided according to the weak links in the cognition of VTE prevention of nurses in high-risk surgical departments to improve the quality of VTE prevention and nursing, thus reducing the incidence rate of perioperative VTE in these patients.

Objective To investigate the postoperative nausea and vomiting (PONV) in scoliosis children and to explore its influencing factors so as to provide a basis for clinical nursing intervention. MethodsFrom June 2017 to December 2018, we selected 417 scoliosis children with orthopedic surgery in Orthopedics Department at Chinese Academy of Medical Sciences & Peking Union Medical College Hospital by convenience sampling. The incidence of PONV, general information, disease data and surgery were collected and Logistic regression was used to analyze the influencing factors of PONV in children undergoing scoliosis orthopedic surgery. ResultsThere were 282 (67.63%) children with PONV within 24 hours after surgery including 221 cases in the early stage and 61 in the late stage. Simple correlation showed that there were statistical differences in the incidence of PONV within 24 hours among children with different ages, types of scoliosis, history of PONV or motion sickness of children, improvement rate of scoliosis correction, using of patient-controlled analgesia, fasting time before surgery, surgery time and hemoglobin of children (P＜0.05). Logistic regression showed that the influencing factors of PONV of children included surgery time, ages, improvement rate of scoliosis correction, hemoglobin, fasting time, history of PONV or motion sickness with statistical differences (P＜ 0.05). ConclusionsChildren after scoliosis correction have the high incidence rate of PONV. Nurses should fully assess the risk of PONV in children with the scientific evaluation methods to reduce the fasting time before surgery of children. Nurses should pay more attention to children with high risk of PONV and take measures to reduce and avoid the occurrence of PONV.