Objective To develop the Expert Consensus on Sensitive Indicators for Assessment of the Quality of Nursing in Operating Theatre and provide a scientific and practical guidance for improving the quality of nursing in operating theatre.Methods The writing team established by the Operating Room Nursing Professional Committee of Guangdong Nursing Association conducted systematic literature retrieval and screening,and used the updated clinical Guidelines for Research and Evaluation Ⅱ in UK 2017.AGREE Ⅱ and the evidence evaluation system of the Australian JBI(Joanna Briggs Institute,JBI)Evidence-Based Health Care Center evidence level system(2016 Edition)comprehensively analyzed the evidence related to the sensitive indicators for evaluating the quality of operating room nursing and the suggestions of the writing group members.The first draft was formed based on the three-dimensional quality evaluation theoretical framework of"structure-process-result".Through the Delphi method,after two rounds of expert consultations and members'votes,the first draft was deeply revised and improved.Results Based on the three-dimensional quality evaluation theoretical framework of"structure-process-outcome"proposed by American scholar Donabedian,the expert consensus finally included five primary indicators:basic nursing quality,quality indicators of patient safety,quality indicators of hospital infection control,quality indicators of medication and safety management,and quality indicators of specialised nursing in operating theatre.The secondary indicators consisted of one structural indicator(management of commonly used instrument and equipment in operating theatre)and 17 process indicators(e.g.,infusion and blood transfusion management,body temperature management,etc.).The tertiary indicators included 26 process indicators and 11 outcome indicators(e.g.,incidence of adverse reactions of infusion during surgery,incidence of intra-operative hypothermia,etc.).Conclusion The evidence-and guideline-based Expert Consensus on Sensitive Indicators for Assessment of the Quality of Nursing in Operating Theatre based on eviclence and guidelines was established through rigorous evidence-based methods.It is operational and practical,and offers theoretical support and practical guidance for the managers of operating theatre to improve the quality of nursing.

Objective To explore the mediating effect of coping styles on the early postoperative cognitive appraisal of health and stigma in patients with radical prostatectomy,so as to provide a reference for an early intervention in postoperative stigma.Methods Convenience sampling was used to select 223 patients who received radical prostatectomy at 5 Tier-ⅢA hospitals in Guangzhou from November 2022 to December 2023.Data were collected using the demographic data questionnaire,social impact scale,brief health cognition appraisal scale and medical coping style scale.Pearson correlation analysis was performed to examine the correlations between the stigma,health cognition appraisal and coping styles.Structural equation modelling was employed to analyse the mediating effect of coping styles on the health cognition appraisals and stigma.Results A total of 210 patients completed the study.The score of stigma for the patients after the radical prostatectomy was(49.46±13.56).Stigma exhibited positive correlations with negative cognitive appraisals(threat and harm)and negative coping styles(avoidance and submission)(both P<0.01).There were negative correlations between stigma and challenging cognitive appraisal and confrontation coping style(both P<0.01).Submission coping style played a mediating role between the cognitive appraisal of health(harm,threat and challenge)and stigma(β=0.072,0.075,-0.121,all P<0.01),accounting for 14.06％,23.15％and 100.00％,respectively,of the total effect.Conclusion Submission coping style is the mediator between the early postoperative cognitive appraisals and stigma in patients with radical prostatectomy.Negative cognitive appraisal positively predicts stigma through the submission coping style,while challenging cognitive appraisal negatively predicts stigma through the submission coping style.Caregivers should assess the early coping styles of patients after surgery,guide patients to correctly cope with the disease,and help them to avoid submissive responses to the postoperative stress hence to reduce the sense of stigma.

Objective To develop a rehabilitation nursing model for knee osteoarthritis(KOA)of external treatment in traditional Chinese medicine(TCM).Methods Between February and June 2023,a preliminary KOA rehabilitation nursing model was developed through literature search and semi-structured interview method.Two rounds of Delphi consultations were conducted with the selected experts,to establish a rehabilitation nursing model for KOA of TCM external treatment.Results A total of 24 experts from different regions participated in the consultation.The final rehabilitation nursing model of TCM external treatment for KOA included 3 primary indicators,16 secondary indicators and 91 tertiary indicators.The response rates from the two rounds of expert consultation were 96.00%and 100.00%,respectively,and the rates of expert opinion proposal were 58.33%and 8.33%,respectively.The expert authority coefficient were 0.906 and 0.923.The two rounds of expert consultation were 0.137 and 0.236 in Kendall's coefficient of concordance(W),with statistically significant differences(both P<0.001).The importance scores of each item in the second inquiry ranged from 3.75 to 4.88,and the coefficient of variation ranged from 0.07 to 0.30,and the full score ratio ranged from 20.83%to 87.50%.Conclusion The rehabilitation nursing model for KOA of TCM external treatment developed in this study is significant,scientific and feasible.It provides a guidance for medical professionals.

Objective To develop a postoperative precision nursing program for children with obstructive sleep apnea-hypopnea syndrome(OSAHS),so as to provide references for the improvement of nursing quality for children with OSAHS.Methods Literature in precision nursing for children with OSAHS was systematically reviewed and summarised based on precision nursing theory and a postoperative precision nursing program was drafted.Using the Delphi's Method,two rounds of expert consultation were conducted and the postoperative precision nursing program for children with OSAHS was revised and finalised.Results The response rates of the two rounds of expert consultation were 100.00%with the expert authority coefficient of 0.875.The Kendall coefficient of concordance(W)of levels 1,2 and 3 indices in the second round of expert consultation were 0.289,0.203,0.187,respectively(all P<0.01).The importance score of each inclicator ranged from 4.50～4.94.The coefficient of variations for the three-level indices ranged from 0.05 to 0.21.The finalised program composed 8 level-1 indices(postoperative position assessment,intervention,prevention and care of bleeding,maintaining postoperative airway patency,postoperative nausea and vomiting care,postoperative pain assessment and care,dietary care,complication prevention and care,discharge guidance),16 level-2 indices,and 22 level-3 indices.Conclusion The postoperative precision nursing program for the children with OSAHS is scientific,innovative and applicable.It provides clinical references for nursing of the children with OSAHS.

Objective To explore the effect of follow-up management based on the digital information platform on the compliance of early screening and follow-up of liver cancer in patients with chronic liver diseases,and to provide a management method for clinical practice.Methods Convenience sampling was adopted to include 3,959 patients who had chronic liver diseases and visited the outpatient clinic of the Department of Infectious Liver Diseases in our hospital from January 2022 to December 2023.Before the application of the digital information platform for management,it was the medical staff of the Infectious Liver Disease Department who conducted telephone follow-ups and handwritten registrations for patients with chronic liver diseases within one week after their visits.After management,A liver cancer prediction model installed in the digital information platform of the hospital automatically collected data of the patients,including information about the diseases and results of examinations for intelligent risk stratification of liver cancer.The nurses who were in charge of the follow-up performed individualised follow-up reviews based on the levels of risk.Follow-up re-visit rate of the patients in very high-and high-risks were calculated.Scores of chronic disease self-efficacy and medication compliance were compared before and at 3 months after the follow-up management.Results A total of 3,860 patients completed the study.After the follow-up management,the total follow-up re-visit rate of the patients was 88.2%(1,818/2,062)and that of the high-risk patients was 95.3%(246/258)in 2022,while those in 2023 were 94.0%(1,691/1,798)and 98.3%(232/236),respectively.After 3 months of follow-up management,scores for medication compliance and chronic disease self-efficacy showed significant improvement in comparison with those before the implementation of follow-up management(P<0.001).Conclusion The follow-up management based on a digital information platform is suitable for screening of early liver cancer in the patients with chronic liver diseases,as it improves the re-visit rate of patients for follow-up,medication compliance and self-efficacy.

Objective To develop an ICU patient care difficulty index based on psychosocial factors and to evaluate its reliability and validity,thereby providing a comprehensive tool for assessing the difficulties in ICU patient care.Methods Guided by Guarinoni theory,an index system was developed through systematic literature reviews,semi-structured interviews,two rounds of Delphi expert consultation and the analytic hierarchy process.Based on the drafted system,a questionnaire was formulated.The tests for validity and reliability were conducted on 290 patients selected by convenience sampling.Results The finalised ICU patient care difficulty index system was composed of 5 primary indices(the general condition of the patient,disease condition,nursing condition,social support,and organizational characteristics),13 secondary indices and 27 tertiary indices.The Kendall's coefficient of coordination W values were 0.380 and 0.498,respectively,indicating a statistically significant agreement(both P<0.001).The system demonstrated a robust reliability(Cronbach's α=0.896)and a good internal consistency.Validity was confirmed through a scale level-content validity index(S-CVI)of 0.94 and the item level-content validity indices(I-CVI)ranged from 0.87 to 1.00.Structural validity analysis,based on 8 extracted public factors,showed a cumulative variance contribution rate of 66.34%.Conclusion The ICU patient care difficulty index system shows a high reliability and validity,making it a valuable tool for accurately quantification of the difficulty in ICU patient care.This system provides a scientific basis for allocation of ICU nursing resource and performance distribution.

Objective To search,evaluate and summarise the best evidence on non-drug intervention for nipple pain or injury in breastfeeding mothers.Methods Based on the"6S pyramid"evidence model,desktop searches were conducted on databases of UpToDate,Joanna Briggs Institute evidence-based practice database(JBI),National Guideline Clearinghouse(NGC),National Institute for health and Care Excellence(NICE),Guidelines International Network(GIN),Registered Nurses'Association of Ontario(RNAO),American College of Obstetricians and Gynecologists(ACOG),Medlive,Chinese Medical Association(CMA)website,Breastfeeding Medical Association(BMA),CNKI,Wanfang Data,SinoMed,Cochrance Library,PubMed,Embase,Web of Science,and CINAHL for literature in non-drug interventions for nipple pain or injury in breastfeeding women.The literature included clinical guidelines,decisions,recommended practices,evidence summaries,expert consensus,systematic reviews and randomized controlled trials(RCTs).The searched databases spanned from 1st January,2013 to 30th April,2024.Two researchers who were trained in evidence-based nursing independently evaluated the methodological quality,extracted and integrated evidence from eligible literature.Results A total of 15 documents were included,consisting of 5 clinical guidelines,2 clinical decisions,1 expert consensus,6 systematic evaluations and 1 RCT.Thirty-one pieces of evidence were summarised across 4 categories:accurate perinatal assessment,feeding guidance,non-drug intervention and health education.Conclusion The summarised best evidence on non-drug intervention for nipple pain or injury in breastfeeding women provides an evidence-based basis for clinical healthcare professionals.

Objective To translate the nursing time management scale(NTMS)into Chinese and test its reliability and validity,hence to provide a tool for evaluating the time management among nurses in China.Methods Authorised by the author on June 30th,2023,the English version of NTMS was translated into a Chinese version through forward translation,reverse translation,cross-cultural debugging and pre-test by using Brislin translation model.Between September 2023 and January 2024,a convenience sampling method was employed to select a total of 409 nurses as the test subjects from five hospitals of Grade IIA and above in Dongguan.Then the reliability and validity of the translated version of NTMS were tested.Results All 409 nurses completed the tests.The Chinese version of NTMS included three dimensions comprising 15 items:6 in nursing work planning and goal setting,3 in organisation of nursing work and 6 in coordination of nursing work.It was found that the mean scale content validity index(S-CVI/Ave)was 0.920,and the item-level CVI(I-CVI)ranged from 0.840 to 1.000.The overall Cronbach's α coefficient of the scale was 0.894,with 0.700 for the split-half reliability coefficient of and 0.942 for the retest reliability.The Cronbach's α coefficient of each of the 3 dimensions ranged from 0.781 to 0.901,with the split-half reliability coefficient from 0.823 to 0.870 and the retest reliability from 0.692 to 0.965.In the exploratory factor analysis,the KMO value was 0.904.The statistic test of Bartlett's sphericity was 3941.503(P<0.05),with the factor load range of each entry from 0.629 to 0.838.The cumulative variance contribution rate was 67.672%.Conclusion The translated Chinese version of the nursing time management scale demonstrates good reliability and validity.It can be applied as an effective evaluation tool in the nursing time management.

Objective To systematically search,evaluate and summarise the best evidence for the management of swallowing disorders in senile dementia,and provide evidence for clinical practice.Methods Systematic search of guidelines,expert consensus,evidence summaries,systematic reviews on the management of swallowing disorders in dementia patients on databases and clinical decision support systems including BMJ Best Clinical Practices,UpToDate,International Guidelines Collaboration Network(IGCN),National Institute for Health and Care Excellence(NICE),Scottish intercollegiate guidelines network(SIGN),national guideline clearinghouse(NGC),Registered Nurses Association of Ontario(RNAO),New Zealand Guidelines Group(NZGG),World Health Organization(WHO),Medlive,PubMed,Cochrane Library,Embase,Web of Science,Joanna Briggs Institute(JBI),CNKI,Wanfang,VIP,SinoMed,the website of the European Society for Swallowing Disorders(ESSD)and Japanese Society of Dysphagia Rehabilitation(JSDR).Clinical decisions,guidelines,expert consensus,evidence summaries,systematic reviews,and clinical trial studies on the management of swallowing disorders in dementia patients were searched.The search was from inception to 30th November,2023.Two researchers trained in evidence-based nursing systems conducted literature screening and data extraction,and determined appropriate evaluation tools to evaluate the quality of the included literature,extracted and graded the evidence,and finally summarised the best evidence suitable for the management of swallowing disorders in dementia patients.Results A total of 8 literature were included,covering 1 guideline,1 clinical decision,4 evidence summaries,and 2 systematic reviews.Finally,19 pieces of evidence were collected from 5 aspects,including screening and evaluation,feeding behaviour management,auxiliary training,education and training,and follow-up monitoring.Conclusion The best evidence summarised in this study provided evidence-based reference for the management of swallowing disorders in patients with dementia by healthcare workers.

Objective To search,evaluate and summarise the best evidence on pre-rehabilitation before surgery for elderly patients with hip fracture so as to provide an evidence-based basis for further standardisation in clinical practice.Methods Based on the"6S Pyramid"evidence model,desktop searches were conducted across databases and websites including Medlive,BMJ Best Practice,UpToDate,the World Health Organization,the Guidelines International Network(GIN),British National Institute for Health and Care Excellence(NICE),American National Guideline Clearinghouse(NGC),Canadian Medical Association:Clinical Practice Guidelines Infobase(CMA),Scottish Intercollegiate Guidelines Network(SIGN),the Registered Nurses'Association of Ontario(RNAO),American College of Sports Medicine(ACSM),American Academy of Orthopaedic Surgeons(AAOS),European Society for Clinical Nutrition and Metabolism(ESPEN),American Society for Parenteral and Enteral Nutrition(ASPEN),the Enhanced Recovery After Surgery Society(ERASS),Cochrane Library,Joanna Briggs Institute,PubMed,CINAHL,Web of Science,Embase,Scopus,Science Direct,CNKI,Wanfang Data,Vip,and SinoMed.The research targeted evidence on pre-rehabilitation in elderly patients with hip-fracture before surgery,encompassing clinical decisions,guidelines,evidence summaries,best practices,expert consensus,systematic reviews and randomized controlled trials(RCTs).The search items spanned from the inception of database to 31st December,2023.Two researchers trained with evidence-based knowledge evaluated the quality of the included literature and extracted and summarised the evidence.Results A total of 14 documents were included,consisting of 2 clinical decisions,4 guidelines,1 best practice,4 expert consensus and 3 systematic reviews.Evidence was summarised into 7 domains from 25 pieces of evidence:multidisciplinary management,preoperative assessment,preoperative health education,multi-modal analgesia,nutritional management,exercise intervention and assessment and prevention of complication risks.Conclusion The best evidence summarised in this study provides a basis for pre-rehabilitation in elderly patients with hip fracture before surgery.Nurses should adapt the findings to specific contexts,standardise the preoperative rehabilitation procedures,and improve clinical outcomes for the patients.