By integrating the concept of narrative medicine and relevant models and tools into the Doctor-patient Communication course， this paper expounds the connotation of narrative medicine under the context of “new medicine” and “big health” and the practical significance of the shift to narrative in Doctor-patient Communication course in three aspects： academic frontier， social needs and practical needs. This paper analyzes the four dimensions of innovation that narrative medicine， as the frontier of the discipline， historical accumulation， educational philosophy and professional skills， provides for the Doctor-patient Communication course， and explores the effective path to realize the narrative transformation of the course. It is expected to achieve the purpose of forging students’ humanistic medical skills and literacy through teaching innovation， realizing the coordination of medical education and competency orientation， adapting to the psychological and social increase， the change of people and health， and promoting the reform of the supply side of medical talents.

Objective:To explore the current status of vicarious posttraumatic growth (VPTG) among emergency nurses, and analyze its influencing factors and pathways of action.Methods:From March to May 2022, convenience sampling was used to select 532 emergency nurses from 20 public general hospitals in Anhui Province as the research subject. A survey was conducted on emergency nurses using the General Information Questionnaire, Posttraumatic Growth Inventory, Chinese Version of the Interpersonal Reactivity Index, Connor-Davidson Resilience Scale, and the Multidimensional Scale of Perceived Social Support. AMOS 24.0 software was used to establish the structural equation model and analyze the path relationships between variables.Results:A total of 532 questionnaires were distributed, and 480 valid questionnaires were collected, with an effective response rate of 90.23% (480/532). The score of the Posttraumatic Growth Inventory for 480 emergency nurses was (49.35±15.82). Empathy, psychological resilience, and perceived social support all had a positive impact on VPTG, with total effect values of 0.503, 0.261, and 0.163, respectively. Empathy directly or indirectly affected VPTG through perceived social support and psychological resilience. Perceived social support indirectly affected VPTG through psychological resilience, and psychological resilience directly affected VPTG.Conclusions:VPTG of emergency nurses is directly and/or indirectly positively influenced by empathy, psychological resilience, and perceived social support. Nursing managers should pay attention to the interaction between factors, take effective measures based on the association between factors, and promote the positive transformation of emergency nurses after trauma.

Objective:To understand the current status of core measures of enhanced recovery after surgery (ERAS) nursing in Anhui Province and analyze its promotion strategies, so we can provide reference for further implementation and promotion of clinical practice guidelines of ERAS.Methods:Design a Development Questionnaire of Enhanced Recovery After Surgery in Anhui Province based on the Clinical Practice Guidelines for Enhanced Recovery After Surgery in China (2021 edition) (I) and, a cross-sectional survey was conducted on surgical nurses in 132 secondary and above hospitals in Anhui Province from July to September 2023 by the convenience sampling method.Results:A total of 1 375 nurses from 13 cities in Anhui province participated in the survey. The nurses′ awareness rate of ERAS concept was 100.00%, but only 52.51% (722/1 375) of the nurses had received standardized ERAS training, and only 26.11% (359/1 375) of the nurses indicated that they had a multidisciplinary team such as medical care, anesthesia and nutrition were involved in the implementation of the ERAS. Nearly 38.33% (527/1 375) of the nurses said that the department lacked the relevant nursing quality control system, and the overall implementation rate of quality control training, development, feedback and monitoring was not high. Only 55.71% (766/1 375) of nurses reported that a quality control team has been established within their department, and only 40.44% (556/1 375) of departments conduct monthly checks on the implementation and progress of ERAS. In terms of the implementation of core measures, preoperative thromboprevention therapy, intraoperative temperature monitoring and management, postoperative multimodal analgesia were better; however, the implementation of preoperative fasting time ≤ 6 h, water ban time≤ 2 h, oral carbohydrate drinks or clean streaming drinks, oral intake of enteral nutritional supplementation when less than 60% of the normal amount was poor.Conclusions:There are still many deficiencies in the overall development of ERAS nursing in Anhui Province, and the implementation level of core measures also needs to be improved. It is necessary to combine the concept of precision nursing, strengthen the whole process management and quality control, so as to promote the clinical practice and promotion of ERAS.

Objective:To understand the current status of core measures of enhanced recovery after surgery (ERAS) nursing in Anhui Province and analyze its promotion strategies, so we can provide reference for further implementation and promotion of clinical practice guidelines of ERAS.Methods:Design a Development Questionnaire of Enhanced Recovery After Surgery in Anhui Province based on the Clinical Practice Guidelines for Enhanced Recovery After Surgery in China (2021 edition) (I) and, a cross-sectional survey was conducted on surgical nurses in 132 secondary and above hospitals in Anhui Province from July to September 2023 by the convenience sampling method.Results:A total of 1 375 nurses from 13 cities in Anhui province participated in the survey. The nurses′ awareness rate of ERAS concept was 100.00%, but only 52.51% (722/1 375) of the nurses had received standardized ERAS training, and only 26.11% (359/1 375) of the nurses indicated that they had a multidisciplinary team such as medical care, anesthesia and nutrition were involved in the implementation of the ERAS. Nearly 38.33% (527/1 375) of the nurses said that the department lacked the relevant nursing quality control system, and the overall implementation rate of quality control training, development, feedback and monitoring was not high. Only 55.71% (766/1 375) of nurses reported that a quality control team has been established within their department, and only 40.44% (556/1 375) of departments conduct monthly checks on the implementation and progress of ERAS. In terms of the implementation of core measures, preoperative thromboprevention therapy, intraoperative temperature monitoring and management, postoperative multimodal analgesia were better; however, the implementation of preoperative fasting time ≤ 6 h, water ban time≤ 2 h, oral carbohydrate drinks or clean streaming drinks, oral intake of enteral nutritional supplementation when less than 60% of the normal amount was poor.Conclusions:There are still many deficiencies in the overall development of ERAS nursing in Anhui Province, and the implementation level of core measures also needs to be improved. It is necessary to combine the concept of precision nursing, strengthen the whole process management and quality control, so as to promote the clinical practice and promotion of ERAS.

Objective:To investigate the latent classes and influencing factors of vicarious posttraumatic growth among emergency nurses.Methods:Convenience sampling method was used to select the 498 emergency nurses of 20 public general hospitals in Anhui province as the survey objects. The general information questionnaire and Posttraumatic Growth Inventory were used to investigate. Latent class analysis was used to classify vicarious posttraumatic growth of emergency nurses, and the influencing factors of latent classes were analyzed by binary logistic regression.Results:There were two latent classes of vicarious posttraumatic growth of emergency nurses including high growth-high fluctuation group (24.1%, 120/498) and low growth group (75.9%, 378/498). Binary logistic regression analysis showed that professional title, average monthly income and self-rated health status were the factors influencing the latent classes (all P<0.05). Conclusions:There are obvious classification characteristics of vicarious posttraumatic growth among emergency nurses. Nursing managers should formulate and implement targeted intervention measures according to the classification characteristics and influencing factors to improve their vicarious posttraumatic growth level.

Objective:To summarize the relevant evidence of environmental management for preventing delirium in ICU patients, so as to provide references for delirium management in ICU patients.Methods:Evidence-based questions were constructed according to the PIPOST model, and relevant clinical decisions, guidelines, expert consensus, systematic reviews and evidence summaries published by various guideline websites, evidence-based databases and comprehensive databases at home and abroad were systematically searched according to the evidence resource "6S" model. The search period was from the establishment of databases to September 3, 2022. Two researchers independently conducted literature quality evaluation using corresponding literature quality evaluation tools. The Joanna Briggs Institute (JBI) Evidence Pre-grading and Evidence Recommendation Grading System (2014 Edition) was used to grade and recommend included evidence.Results:A total of 30 articles were included, including 5 guidelines, 2 expert consensus, 1 clinical recommended practice, 4 evidence summaries and 18 systematic reviews. A total of 36 best evidences were summarized from 5 aspects, including environment optimization, sleep promotion, cognitive stimulation, positioning and orientation function, and safety protection.Conclusions:Medical staff should manage the ICU environment based on evidence-based evidence to prevent or reduce the occurrence of delirium in patients.

Frailty and trauma are closely related, and together affect the health outcomes of elderly trauma patients. However, insufficient attention has been paid to the frailty of elderly trauma patients in China. This paper reviews the relationship between frailty and trauma, assessment tools and management of frailty in elderly trauma patients, in order to provide a new perspective of nursing care for elderly trauma patients in China and to provide references for carrying out research on frailty in elderly trauma patients.

OBJECTIVE: To study the working experience of COVID-19 care nurses. METHODS: Twenty two nurses taking care of COVID-19 patients were interviewed by means of descriptive phenomenology. All the data were transcribed and recorded, and then processed into WORD documents. The Colaizzi 7 footwork was used to classify, encode, establish nodes and extract themes based on Nvivo11.0 software. RESULTS: Two main themes were extracted: one is the positive feelings of nurses, including the sense of professional mission and pride, the sense of achievement and happiness, the improvement of self-worth and ability, the powerful support system and the power of role models; the other is the negative experience of nurses, including the worry and anxiety at work, the lack of experience and trust, the difficulty of work, and the inconvenience of isolating life. CONCLUSIONS s While fully affirming the work value of nurses, it is necessary for the society, hospitals and patients to give extensive and continuous support, care and respect to nurses, so as to stimulate their working enthusiasm and sense of professional achievement. Hospital managers need to implement all kinds of security work, meet the safety needs of nurses, pay attention to the physical and mental health of nurses, strengthen the training of nursing talents for critical and severe diseases and infectious diseases, improve the allocation of human resources, and enhance the ability of material allocation and reserve for major health events, so as to make adequate preparations for coping with public health events in the future.
Betacoronavirus ; Coronavirus Infections ; Hospitals ; statistics & numerical data ; Humans ; Nurses ; statistics & numerical data ; Pandemics ; Pneumonia, Viral ; Qualitative Research ; Workplace ; statistics & numerical data

Objective: To explore the quality management of critical patients in the process of medical helicopter rescue and transshipment. Methods: After receiving the rescue and transshipment task for 10 critically ill patients, the Emergency Department quickly established the rescue quality management team under the direction of the dean: with helicopter on-site rescue and transshipment team, in-hospital pick-up and transshipment team, logistic support team and coordination command group; full medical security assessment: to prepare all emergency supplies, drugs, instruments and equipment in a predictable manner, and all within the effective period, completed. The success rate is 100%. The formulation of rescue plan: formulating individualized emergency plan, pre-examination and triage evaluation plan, transporting and implementing process plan; unblocked green channel: setting up rescue room as rescue preparation area; radiology department, laboratory department, pharmacy, B-ultrasound room, electrocardiogram room, emergency transfer elevator, medical housekeeper and other departments ensure the green channel unblocked, safety logistic support team dedicated personnel management. To manage the area from apron to emergency hall and rescue room, smooth transit routes, and prepare for emergency treatment in emergency intensive care unit and specialized intensive care unit. Specialized organizations are responsible for: Department directors, head nurses and quality control team leaders to organize and coordinate quality management work. Results: All 10 critically ill patients were safely and smoothly transported to hospital for emergency treatment without any adverse events. Six patients received emergency intensive care, three orthopaedic care, one hand-foot surgery care, and 10 critically ill patients were discharged from hospital in time and safely through various specialties. Conclusion The successful rescue and safe transshipment of 10 critically ill patients reflects the good beginning of the development of medical helicopter rescue in our province, and forms a complete, organized, targeted, planned and implemented team rescue system, which greatly improves the quality management level of medical helicopter rescue and transshipment.

Objective: To explore the effect of hyperbaric oxygen preconditioning with different frequency on the survival rate of flap and ischemia-reperfusion injury in rats after transplantation, and to explore the best preconditioning conditions to improve the survival rate of rat flaps after transplantation. Methods: Thirty-six Sprague Dawley rats were randomly divided into four groups according to the random number table method, 9 groups in each group.Four groups of rats were pretreated with hyperbaric oxygen pretreatment for 0, 2, 4, and 6 days before the operation, control group, pretreatment 2 d group, pretreatment 4 d group, and pretreatment 6 d group. Taking the midline of the back of the rat as the axis, an ultra-long random flap with a pedicle at the tail end and about 1 cm from the superior iliac spine was designed and cut to a size of 10.0 cm×2.5 cm. The survival of the flaps in each group was observed and the final survival area and survival rate of the flaps were measured on the 7th day after surgery. On the 7th day after operation, the tissue was taken at a distance of 5 cm from the pedicle, and the histopathology was observed; The content of superoxide dismutase (SOD) and malondialdehyde (MDA) in flap tissue was detected by immunohistochemistry, and the expression rate of positive cells in each group was calculated. Immunofluorescence was used to detect the expression of interleukin-6 (IL-6) in the flap tissue. Results: On the 7th day after the operation, the survival area and survival rate of the transplanted flaps in the hyperbaric oxygen pretreatment group were significantly higher than those in the control group (P<0.05), and the pretreatment 4 d and 6 d groups were significantly higher than the pretreated 2 d group (P<0.05), but there was no significant difference between the pretreated 4 d group and the 6 d group (P=0.095). Pathological observation on the 7th day after operation showed that there was some necrosis in the control group, the vascular cells in the pretreated 2 d group had more vascular structures, and more neovascularization was observed in the pretreated 4 d group. The inflammatory cells were the least in the 6 d pretreatment group, and the neovascularization was the same as the pretreatment 4 d group. The absorbance A value of SOD in the control group was 0.009 7±0.000 3, and the positive expression rate was 20%, which was significantly lower than that in the hyperbaric oxygen pretreatment group. The difference was statistically significant (P<0.05). However, the absorbance A value of MDA in the control group was 0.055 1±0.003 0, and the positive expression rate was 55%, which was significantly higher than that in the hyperbaric oxygen pretreatment group. The difference was statistically significant (P<0.05). Among them, the SOD absorbance A value of the pretreated 2 d group was 0.023 8±0.003 0, and the positive expression rate was 30%, which was lower than the pretreatment 4 d group (absorbance A value 0.046 9±0.003 0, positive expression rate 35%) and 6 d group (absorbance A value 0.047 2±0.003 6, positive expression rate 40%), The MDA absorbance A value of the pretreated 2 d group was 0.037 2±0.003 2, and the positive expression rate was 30%, which was higher than the pretreatment 4 d group (absorbance A value 0.014 7±0.002 4, positive expression rate 5%) and 6 d group (absorbance A value 0.017 0±0.001 8, positive expression rate 10%), the difference was statistically significant (P<0.05). However, there was no significant difference in the expression of SOD and MDA between the pretreated 4 d group and the pretreated 6 d group (P>0.05). The expression of IL-6 in the hyperbaric oxygen pretreatment group was significantly lower than that in the control group (absorbance A value 44.937 0±0.594 0), the difference was statistically significant (P<0.05). The absorbance A value in the pretreated 2 d group was 41.698 0±0.724 0, which was significantly higher than the pretreatment 4 d group (absorbance A value 34.049 0±0.323 0) and 6 d group (absorbance A value 33.524 0±0.639 0). The difference was statistically significant (P<0.05). There was no significant difference in the expression of the pretreated 4 d group compared with the 6 d group (P=0.068). Conclusions Hyperbaric oxygen preconditioning can significantly promote the survival of rat flaps after transplantation. Preoperative hyperbaric oxygen preconditioning once daily for 4 consecutive days, can enhance the tolerance of flap tissue to ischemia and anoxia and reduce tissue ischemia-reperfusion injury.