Objective To establish an indicator system for evaluation of entrustable professional activity(EPA)of PICC specialist nurses hence to provide a reference in evaluation of the post competency.Methods Through literature review and expert correspondence,two rounds of expert consultations were conducted with 18 PICC specialist nurses to determine the indicators for EPA evaluation.Results The effective recovery rate of the consultation questionnaires was 100.00%from the 2 rounds of expert consultations with the 18 PICC specialist nurses.In the second round of consultation,the expert authority coefficient was 0.94.The Kendall harmony coefficients for first-level secord-level and tertiary indicator were 0.388,0.257 and 0.159,respectively(all P<0.001).Four primary evaluative indicators were extracted,covering health assessment,professional skills operation,clinical nursing and teaching and research.In addition,4 first-level indicators(health assessment,professional skill operation,clinical nursing and teaching and scientific research),a total of 11 second-level indicators(mortal history collection,puncture site and catheter selection,occupational protection,specialist nursing operation technology,PICC venous safety assessment and management,first aid nursing skills,health guidance,educational consultation,communication and collaboration,teaching guidance,nursing scientific research application and professional development)and 47 tertiary indicators were included.All indicators scored between 4.56～5.00 for importance in the second round of consultation,between 4.50～4.94 for observability,and between 4.61～5.00 for reflecting the corresponding core competencies.Conclusion The EPA indicator system for evaluation of PICC specialist nurses is scientifically reliable and comprehensive.It can serve as an objective quantitative tool in evaluation of the post competency of PICC specialist nurses.

Objective:To explore the application effect of the P-SAFE (Protection-Soothe, Antithrombotic,Foodstuff,Eudipsia) nursing model based on enhanced recovery after surgery (ERAS) in patients with hemifacial spasm after microvascular decompression surgery, and provide a protocol for the rapid recovery of patients.Methods:A non-randomized quasi-experimental study was used to conveniently select patients with hemifacial spasm who underwent microvascular decompression in Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 2022 to December 2023. Among them, 80 patients treated with the traditional nursing management model from January to December 2022 were selected as the control group, while 94 patients treated with the P-SAFE nursing model under the ERAS concept from January to December 2023 were selected as the experimental group. The two groups were compared in terms of incidence of perioperative hunger and thirst, nausea and vomiting, thrombus, pain, adverse events as well as length of hospital stay, hospital costs, and pre-discharge nursing satisfaction.Results:Among the 80 patients in the control group, there were 19 males and 61 females, with an age of (54.98 ± 7.44) years. Among 94 patients in the experimental group, there were 15 males and 79 females, aged (54.93 ± 8.71) years. The incidences of perioperative hunger, thirst, nausea and vomiting, thrombosis and adverse events in the experimental group were 29.79%(28/94), 29.79%(28/94), 7.45%(7/94), 0 and 0, respectively, all of which were better than those in the control group, which were 45.00%(36/80), 47.50%(38/80), 23.75%(19/80), 8.75%(7/80), and 5.00%(4/80), respectively, pain score in the experimental group was 0(0, 1.25) points, lower than 0(0, 3.00) points in the control group, the differences were statistically significant ( χ2 values were 4.30 to 9.04, Z=-2.96, all P<0.05). The hospital stays, hospital costs and nursing satisfaction in the experimental group were 9(7, 10) days, 3.97(3.91, 4.31) ten thousand yuan, and 98.00(92.75, 100.00) points, respectively, compared to the control group′s 11 (10, 12) days, 4.90(4.36, 5.08) ten thousand yuan, and 80.00(79.00, 100.00) points. These differences were also statistically significant ( Z=-7.84, -8.57, -5.79, all P<0.05). Conclusions:The P-SAFE nursing mode for patients with hemifacial spasm undergoing microvascular decompression under the concept of ERAS can reduce their perioperative discomfort, reduce the incidence of postoperative complications, improve the prognosis of patients, and help accelerate the recovery of patients.

Objective:To explore the application effect of the P-SAFE (Protection-Soothe, Antithrombotic,Foodstuff,Eudipsia) nursing model based on enhanced recovery after surgery (ERAS) in patients with hemifacial spasm after microvascular decompression surgery, and provide a protocol for the rapid recovery of patients.Methods:A non-randomized quasi-experimental study was used to conveniently select patients with hemifacial spasm who underwent microvascular decompression in Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 2022 to December 2023. Among them, 80 patients treated with the traditional nursing management model from January to December 2022 were selected as the control group, while 94 patients treated with the P-SAFE nursing model under the ERAS concept from January to December 2023 were selected as the experimental group. The two groups were compared in terms of incidence of perioperative hunger and thirst, nausea and vomiting, thrombus, pain, adverse events as well as length of hospital stay, hospital costs, and pre-discharge nursing satisfaction.Results:Among the 80 patients in the control group, there were 19 males and 61 females, with an age of (54.98 ± 7.44) years. Among 94 patients in the experimental group, there were 15 males and 79 females, aged (54.93 ± 8.71) years. The incidences of perioperative hunger, thirst, nausea and vomiting, thrombosis and adverse events in the experimental group were 29.79%(28/94), 29.79%(28/94), 7.45%(7/94), 0 and 0, respectively, all of which were better than those in the control group, which were 45.00%(36/80), 47.50%(38/80), 23.75%(19/80), 8.75%(7/80), and 5.00%(4/80), respectively, pain score in the experimental group was 0(0, 1.25) points, lower than 0(0, 3.00) points in the control group, the differences were statistically significant ( χ2 values were 4.30 to 9.04, Z=-2.96, all P<0.05). The hospital stays, hospital costs and nursing satisfaction in the experimental group were 9(7, 10) days, 3.97(3.91, 4.31) ten thousand yuan, and 98.00(92.75, 100.00) points, respectively, compared to the control group′s 11 (10, 12) days, 4.90(4.36, 5.08) ten thousand yuan, and 80.00(79.00, 100.00) points. These differences were also statistically significant ( Z=-7.84, -8.57, -5.79, all P<0.05). Conclusions:The P-SAFE nursing mode for patients with hemifacial spasm undergoing microvascular decompression under the concept of ERAS can reduce their perioperative discomfort, reduce the incidence of postoperative complications, improve the prognosis of patients, and help accelerate the recovery of patients.

Objective To establish an indicator system for evaluation of entrustable professional activity(EPA)of PICC specialist nurses hence to provide a reference in evaluation of the post competency.Methods Through literature review and expert correspondence,two rounds of expert consultations were conducted with 18 PICC specialist nurses to determine the indicators for EPA evaluation.Results The effective recovery rate of the consultation questionnaires was 100.00%from the 2 rounds of expert consultations with the 18 PICC specialist nurses.In the second round of consultation,the expert authority coefficient was 0.94.The Kendall harmony coefficients for first-level secord-level and tertiary indicator were 0.388,0.257 and 0.159,respectively(all P<0.001).Four primary evaluative indicators were extracted,covering health assessment,professional skills operation,clinical nursing and teaching and research.In addition,4 first-level indicators(health assessment,professional skill operation,clinical nursing and teaching and scientific research),a total of 11 second-level indicators(mortal history collection,puncture site and catheter selection,occupational protection,specialist nursing operation technology,PICC venous safety assessment and management,first aid nursing skills,health guidance,educational consultation,communication and collaboration,teaching guidance,nursing scientific research application and professional development)and 47 tertiary indicators were included.All indicators scored between 4.56～5.00 for importance in the second round of consultation,between 4.50～4.94 for observability,and between 4.61～5.00 for reflecting the corresponding core competencies.Conclusion The EPA indicator system for evaluation of PICC specialist nurses is scientifically reliable and comprehensive.It can serve as an objective quantitative tool in evaluation of the post competency of PICC specialist nurses.

Objective To assess the clinical effectiveness ofWenyang-Gushen-Huayu decoction on treating diabetic nephropathy (DN).Methods One hundred and twenty DN patients in Hospital of Penglai Chinese Medicine were included and randomly divided into treatment group and observation group. Both groups were given conventional treatment, and the treatment group was added withWenyang-Gushen-Huayu decoction. One course of treatment lasted four weeks in both groups and each group was observed for 2 courses. The clinical symptoms, vital signs, urinary albumin excretion rate (UAER), and 24 h urinary proteinwere observed. Results The treatment group showed significantly higher effective rate (93.34%vs.73.33%) than that in the control groupa(χ2=8.640,P=0.003). TheWenyang-Gushen-Huayu decoction significantly improved the symptoms of waist chills (2.47 ± 1.11vs.2.92 ± 1.36,t=1.986), edema of face and feet (1.81 ± 0.96vs.2.14 ± 1.01,t=5.165), fatigue of the gods (2.83 ± 1.12vs.3.51 ± 1.18,t=3.237), UAER (326.4 ± 98.7μg/minvs. 421.5 ± 185.6μg/min;t=3.504) and UP (0.7 ± 0.33 g/24hvs. 1.0 ± 0.37 g/24h;t=1.845).ConclusionsTheWenyang-Gushen-Huayu decoction could improve the symptoms and reduce UAER of DN patients.