Objective:To explore the current status of back patting and sputum drainage nursing performed by nurses in the Neurological Intensive Care Unit (NICU) and their design requirements for a nursing robot, providing a reference for the design of nursing robots for back patting and sputum drainage.Methods:This descriptive qualitative study employed a purposive sampling method. From January to February 2024, semi-structured interviews were conducted with 15 nurses from the NICU of Xuanwu Hospital, Capital Medical University. Data were analyzed using Colaizzi 7-step analysis method.Results:A total of three major issues were identified regarding the current practice of back patting and sputum drainage nursing by NICU nurses: heavy workload and time-consuming; difficulties in patient positioning and maintenance; deficiencies in nursing care. The design requirements for a back patting and sputum drainage nursing robot were categorized into two main themes with 10 sub-themes: functional requirements (turning function, supporting function, intelligent recognition function, abnormality detection with alarm or pause feature, and evaluation of post-percussion effectiveness) ; design requirements (basic functional design, support component design, percussion component design, coordination between support and percussion functions, and overall structural design) .Conclusions:Understanding the design requirements of NICU nurses for a back patting and sputum drainage nursing robot provides valuable insights for developing a safe, scientific, reasonable, and effective robotic system.

Objective:To explore the current status of back patting and sputum drainage nursing performed by nurses in the Neurological Intensive Care Unit (NICU) and their design requirements for a nursing robot, providing a reference for the design of nursing robots for back patting and sputum drainage.Methods:This descriptive qualitative study employed a purposive sampling method. From January to February 2024, semi-structured interviews were conducted with 15 nurses from the NICU of Xuanwu Hospital, Capital Medical University. Data were analyzed using Colaizzi 7-step analysis method.Results:A total of three major issues were identified regarding the current practice of back patting and sputum drainage nursing by NICU nurses: heavy workload and time-consuming; difficulties in patient positioning and maintenance; deficiencies in nursing care. The design requirements for a back patting and sputum drainage nursing robot were categorized into two main themes with 10 sub-themes: functional requirements (turning function, supporting function, intelligent recognition function, abnormality detection with alarm or pause feature, and evaluation of post-percussion effectiveness) ; design requirements (basic functional design, support component design, percussion component design, coordination between support and percussion functions, and overall structural design) .Conclusions:Understanding the design requirements of NICU nurses for a back patting and sputum drainage nursing robot provides valuable insights for developing a safe, scientific, reasonable, and effective robotic system.

Objective:To form an expert consensus on plasma exchange nursing for severe autoimmune encephalitis ( " Consensus" for short) and standardize the practice of plasma exchange nursing for severe autoimmune encephalitis. Methods:After reviewing and summarizing the literature related to plasma exchange of severe autoimmune encephalitis, the relevant nursing evidence was extracted and the draft of Consensus was formed. From September to October 2023, a total of 20 experts were selected to conduct two rounds of expert letter consultation, and then the expert results were analyzed, sort outed and modified to form the final draft of the Consensus. Results:The expert positive coefficient was 100.00% (20/20), the expert judgment basis coefficient was 0.89, the expert familiarity coefficient was 0.85, the expert authority coefficient was 0.87, and the Kendall harmony coefficient was 0.15-0.22 ( P<0.05). The final Consensus included plasma exchange quality control management, preparation and evaluation before plasma exchange, setting and monitoring during plasma exchange, and evaluation and maintenance after plasma exchange. Conclusions:This Consensus is practical and can provide guidance for clinical nursing practice and quality control of plasma exchange in severe autoimmune encephalitis.

Objective:To explore the core competence that Neurology nurses should possess through qualitative research.Methods:In July 2023, a semi-structured interview was conducted by purposive sampling to select 15 clinical nurses and 7 head nurses in Department of Neurology of Xuanwu Hospital, Capital Medical University. Colaizzi 7-step analysis method in phenomenological research was used to analyze data.Results:The core competence model of neurology nurses were summarized into 7 themes, including clinical competence (symptom assessment ability of neurological diseases, critical rescue ability of neurological diseases, specialized skills related to neurological disease treatment), research ability, teaching ability, management ability, personal quality (communication ability, learning ability, teamwork ability), professional quality (patience, responsibility, love, empathy), and the supervision ability of neurology head nurses over nurses (development of continuing education on neurological diseases, promotion of career planning for neurology nurses) .Conclusions:The analysis of the core competence of Neurology nurses provides a basis for improving nursing quality, promoting disease prognosis for patients with neurological disorders, and enhancing their quality of life.

Intrahepatic cholangiocarcinoma (ICC) is a highly malignant tumor with poor prognosis. In the process of clinical diagnosis and treatment, only a small number of patients can receive surgical treatment in time, and the rest often have local infiltration or distant metastasis at the time of presentation, which can only prolong the overall survival by adjuvant therapy. At present, the main adjuvant treatments in clinical practice include chemotherapy, targeted therapy and immunotherapy. This article reviews the progress of systemic therapy and some clinical trials in patients with advanced unresectable ICC, to provide a reference for the clinical diagnosis and treatment of ICC.

Crohn′s disease (CD) -related anorectal stricture is a narrowing lesion that occurs in the distal part of the gastrointestinal tract. The symptoms of anorectal stricture in CD are not obvious in the early stage, but in the later stage, manifest difficulty in defecation, fecal incontinence, and persistent anal pain, often requiring repeated medical and surgical treatment, leading to a dramatic decrease in the patient′s quality of life. The presence of anorectal stricture in patients with CD usually indicates that the intestinal tract, especially rectal inflammation, is not controlled, and the probability of diverting stoma or rectal resection is significantly increased. Clinical diagnosis requires comprehensive detailed physical examination, endoscopy and biopsy, magnetic resonance imaging, etc. Treatment is based on medical therapy, supplemented by endoscopic and instrumental anal surgical intervention when necessary, but there is a lack of standardized treatment protocols. This article reviews the existing pathogenesis, diagnosis, and treatment modalities of this disease to help with clinical diagnosis and treatment.

Crohn′s disease (CD) -related anorectal stricture is a narrowing lesion that occurs in the distal part of the gastrointestinal tract. The symptoms of anorectal stricture in CD are not obvious in the early stage, but in the later stage, manifest difficulty in defecation, fecal incontinence, and persistent anal pain, often requiring repeated medical and surgical treatment, leading to a dramatic decrease in the patient′s quality of life. The presence of anorectal stricture in patients with CD usually indicates that the intestinal tract, especially rectal inflammation, is not controlled, and the probability of diverting stoma or rectal resection is significantly increased. Clinical diagnosis requires comprehensive detailed physical examination, endoscopy and biopsy, magnetic resonance imaging, etc. Treatment is based on medical therapy, supplemented by endoscopic and instrumental anal surgical intervention when necessary, but there is a lack of standardized treatment protocols. This article reviews the existing pathogenesis, diagnosis, and treatment modalities of this disease to help with clinical diagnosis and treatment.

Multiple sclerosis has a long course of disease, a high recurrence rate, and is disabling and fatal. Nurse practitioners play an important role in the management of patients with multiple sclerosis. This article reviews the role of nurse practitioners abroad in multiple sclerosis disease modifying treatment, medication nursing, psychological nursing, and assessment and management of palliative care, so as to provide a reference and inspiration for nurse practitioners in China to manage multiple sclerosis patients.

Objective:To explore the establishment of a cluster intervention strategy by multi-criteria decision analysis (MCDA) to provide a basis for the early removal of indwelling catheters in severe neurological patients.Methods:Through literature retrieval and MCDA, the catheter cluster intervention strategy was constructed, and the expert consultation was adopted to finally form 7 item cluster intervention strategies. The convenience sampling method was used to select 122 patients with severe neurological diseases as the research objects. A total of 61 patients with indwelling catheters from November 2018 to April 2019 were selected as the control group, and routine nursing care was performed according to indwelling catheters. A total of 61 patients with indwelling catheters from May 2019 to October 2019 were selected as the intervention group to compare the success rate of removing catheters, the number of days of indent catheters and the incidence of catheter-associated urinary tract infection ( CAUTI) in the two groups, as well as to analyze the indicators related to indent catheters in the intervention group with different diagnoses. Results:CAUTI incidence, successful catheter removal rate, indwelling days of catheter in the intervention group were 39.3% (24/61), 32.79% (20/61), 17 (14,22) days, which were significantly higher than 59.0% (36/61), 8.19% (5/61), 21 (15, 27) days in the control group, and the difference was statistically significant (χ 2 values were 4.723, 11.775, Z value was -9.211, P<0.05 or 0.01); In the intervention group, stroke patients′ indwelling time of catheter were 7-20 days, and the highest success rate of removing urinary catheters 36.6% (15/41), compared with other diseases, the difference was statistically significant ( Z values were -2.448, -2.109, P<0.05). Conclusion:MCDA construction of early catheter removal strategy can significantly shorten the indwelling time of the catheter in patients with severe neurological diseases, improve the success rate of early catheter extubation, reduce the CAUTI rate, to provide evidence-based basis for clinical nursing.

Objective:To explore the application effect of optimizing the anti-epileptic drug (AED) administration nursing procedure for patients with severe epilepsy at the first time after ICU admission.Methods:A quasi-experiment study was conducted by convenience sampling. The 44 patients with severe status epilepticus admitted in our department from January 2016 to December 2017 were selected as the control group .The 44 patients with status epilepticus admitted in our department from January 2018 to December 2019 were selected as the experimental group .The experimental group was implemented the optimized administration procedure after ICU admission. The control group was implemented the routine administration procedure after ICU admission. Some data of the two groups were compared, including baseline data, first administration time after admission, administration step time, AED dose reserve, and seizures at different time periods and so on.Results:Comparative analysis of the time of the first drug administration after admission into the two groups .The administration time of the control group was 31.0 (10.0-69.0) min, which was significantly longer than that of the experimental group, 25.0 (16.0-31.8) min ( χ2 value was -2.760, P<0.05). Comparison and analysis of the time taken for each step of drug administration: The time taken for step 1(Patient admission—medical order confirmation) in the control group was significantly greater than that in the experimental group ( χ2 value was -2.811, P<0.05); step 2 (medical order confirmation—Prepare medicines)in the control group was significantly greater than that in the experimental group ( χ2 value was -4.327, P<0.05).There was no significant difference in the time taken for step 3(Prepare medicines—Drug delivery to complete)between the two groups ( χ2 value was -1.137, P>0.05). Control group AED reserve ratio 63.6% (28/44), experimental group AED reserve was 100.0% (44/44), and the difference was statistically significant ( χ2 value was 19.556, P<0.05). Epilepsy control in two groups of patients: the total control rate after the first administration of the experimental group was 93.2% (41/44), which was significantly higher than 61.4% (27/44) of the control group ( Z value was -3.445, P<0.001). Conclusion:It can shorten the time to first give AED and improve the patient's clinical symptoms that optimizing the first drug administration procedure for patients with status epilepticus after admission.