Objective To develop a self-care scale for patients with lymphedema after breast cancer surgery and verify its reliability and validity.Methods Based on the model of knowledge,belief and practice,a questionnaire item pool was constructed after literature reviews and qualitative interviews.A questionnaire-based scale was drafted based on the established item pool by carrying out two rounds of consultation with 15 clinical nursing specialists,nursing administrators and nursing educators from 8 provinces or cities in China.Reliability and validity of the scale were tested using convenience sampling,involving 444 patients with breast cancer surgery related lymphedema from 7 general hospitals in Hubei and Henan provinces,China,between May and July 2023.Results The response rates for the two rounds of expert consultation were 93.75%and 93.33%,respectively.The authority coefficients of the two rounds were 0.86 and 0.89,respectively,and the coordination coefficients for the 2 rounds were 0.130 and 0.379,respectively.In the first round,the average importance rating was from 4.33 to 4.93 with the coefficient of variation from 0.05 to 0.19,and the full score ratio from 53.33%to 93.33%.In the second round,the average importance rating ranged from 2.86 to 4.93 with the coefficient of variation from 0.05 to 0.36,and the full score ratios from 7.14%to 92.86%.A total of 421 patients completed the survey.The overall Cronbach's α coefficient of the scale was 0.943,the overall split-half reliability was 0.824,the scale-level content validity index(S-CVI)was 0.912,and the item-level content validity index(I-CVI)of the total scale ranged from 0.857 to 1.000.The KMO value of exploratory factor analysis was 0.919,the Bartrett spherical test value was 4671.724(P<0.001),and the cumulative variance contribution rate was 64.155%.Confirmatory factor analysis showed a good model fit.After the reliability and validity tests,the scale was finalised and determined to consist of three dimensions with 33 items:knowledge(9 items),attitude(6 items)and behaviour(18 items).Conclusion The self-care scale for the patients with lymphedema after breast cancer surgery has demonstrated good reliability and validity,and makes it an effective assessment tool for the patients with lymphedema after breast cancer surgery.

Objective:To provide basis for formulating standardized intervention plan of patients with enterostomy by integrating relevant qualitative studies to systematically evaluate the self-management experience of patients with enterostomy.Methods:PubMed, EMBASE, Web of Science, EBSCO (CINAHL), Joanna Briggs Institute (JBI), The Cochrane Library (central), CNKI, Wanfang databases, and VIP were searched for qualitative research related to the self-management experience of enterostomy patients from establishment to May 2022, the quality of articles were evaluated by the "quality evaluation standard of JBI evidence-based health care center (2014) in Australia", and results were summarized by Meta-integration.Results:A total of 8 studies were included, 22 complete research results were refined, 9 new categories were summarized, and 3 integrated results were obtained: the dilemma and obstacles of self-management, the process and growth of self-management, and the needs and prospects of self-management.Conclusions:The patients with enterostomy was increasing in recent years. The society should pay attention to the psychological problems of patients with enterostomy, strengthen education of disease risk cognition, and improve the construction of comprehensive information platform for self-management of enterostomy patients. By providing multiple support through online and offline channels, we can improve the self-care management ability of enterostomy patients, and enhance the quality of life in patients.

Objective:To analyze the current hotspots of international research on patient safety in recent 10 years, and to provide reference for the scientific research and practical management of patient safety in China.Methods:Based on Web of Science database, CiteSpace visual analysis software was used to analyze the related literature on patient safety collected from January 2009 to December 2018. Word frequency analysis and Co-word clustering were performed on research institutions, authors, countries, journals, cited literature and high frequency keywords.Results:At present, the international research on patient safety is mainly concentrated in European and American higher educational institution with Harvard University as the core; the core journals are The Journal of the American Medical Association, New England Journal of Medicine, Lancet and other journals with the highest international academic influence; the patient safety phase is excavated through keyword co-occurrence cluster analysis. There are 9 international research hotspots, such as safety practice management, safety index research, safety education and safety culture construction. Conclusion:The relevant research background and current situation in the international field of patient safety are in a mature and stable stage. The research team is mainly concentrated in developed areas such as Europe and the United States, and a more closely cooperative and shared research model has been formed. The research hotspot and focus are closely around the multi-disciplinary and multi-field research theme of "patient-centered" advocated by the World Health Organization, which is worthy of domestic researchers' reference and learning. Also, the research and exploration work cored on patient safety domestically needed to be further structured and promoted.

Objective:To retrieve, appraise and summarize the evidence for the airway humidification management of the inpatient with laryngectomy and tracheotomy but nonmechanical ventilation and to provide references for the clinical nursing.Methods:The evidence question was raised based on the study objective. The evidence was retrieved from some databases according to the evidence pyramid model during inception to December, 2018. The literature types included clinical practice guideline, evidence summary, best practice information sheet, recommended practice and systematic review. The quality of the literature were evaluated by the suitable evaluated tool based on their types. The level and recommedation grade of the evidence were appraised by the suitable tools of JBI.Results:Thirteen studies were recruited, including one clinical practice guideline, two evidence summaries, one best practice information sheet and nine systematic reviews. Totally thirteen items of best evidence were summarized and generalized to four categories including assessment, method, liquid and operation of airway humidification.Conclusion:The evidences of the studies are scientific and practical, but on the one hand, it is recommended that when applying the evidences in clinic, it is necessary to assess the clinical situation and chose the proper evidence. And on the other hand, there are lacking of some evidences of airway humidification and the level of some evidences is low. So it needs to create more high level evidences.

Since the outbreak of COVID-19 in Wuhan, cabin hospitals have played an important role in preventing the spread of the epidemic and admitting all the patients and suspected ones. As one of the first three cabin hospitals in Wuhan, Jianghan cabin hospital under care of Wuhan Union Hospital has efficiently fulfilled its purpose of admitting patients of mild symptoms. Measures taken by the cabin hospital include clearing its positioning, optimizing its layout, establishing organization structure, setting up the rules and regulations, and strengthening the prevention and control of hospital infection. This article briefly summed up the operation and management practices of the cabin hospital, and analyzed its management difficulties, hence putting forwards suggestions on medical emergency management system of China, for references of hospitals and authorities in charge.

Objective:To construct the nursing quality evaluation index system for Intensive Care Unit (ICU) aspiration prevention so as to provide a scientific basis for the monitoring and evaluation of nursing quality of ICU inpatients aspiration prevention.Methods:We initially constructed an item pool of quality evaluation index and a questionnaire by taking "structure-process-outcome" three-dimensional quality model as the framework and combining literature retrieval, semi-structured interviews and group discussions. We also used Delphi method combined with analytic hierarchy process to determine the index system and its weight.Results:In two rounds of questionnaires, the response rates were 100% and 96%, and the authority coefficients were 0.894 and 0.912, and the judgment coefficients were 0.960 and 0.964, and the familiarity coefficients were 0.828 and 0.860, and the Kendall's W were 0.072 and 0.189 respectively. The nursing quality evaluation index system for ICU aspiration prevention included 3 first-level indicators (structural indicators, process indicators, and outcome indicators) , 12 second-level indicators and 48 third-level indicators. Conclusions:The nursing quality evaluation index system for ICU aspiration prevention is scientific, reliable and instructive, which provides a scientific decision-making basis for the clinical practice of ICU nurses and improves the ICU nursing quality and guarantees patient safety.

Objective: To investigate the epidemiological data of ventilator-associated pneumonia(VAP) occurred in adults after cardiac surgery and exploring the relationship between ventilator-associated pneumonia related factors, and all purpose is to provide strong theoretical advice and technical guidance for prevent the occurrence of ventilator-associated pneumonia in post-cardiac surgery patients. Methods: Using literature research method to determine 55 VAP related factors, and 21 nursing experts were selected to conduct 2 rounds of enquiries. Based on the results of the consultation, a retrospective questionnaire was formed. A total of 150 patients who underwent ICU mechanical ventilation after cardiac surgery from September 2016 to August 2017 were retrospectively selected. The related factors of VAP and its etiological characteristics were retrospectively observed. Results: Delphi experts consultation results: the response rate two rounds were 86.4% and 100.0% respectively; the coefficient of reliability ascertained the authority of evaluation was 0.857 and 0.903 respectively; Kendall’s W were 0.406 and 0.304 respectively (P all < 0.01). The average incidence of VAP was 25.10/1 000 ventilation days. In the VAP infection group, a total of 84 strains were detected, in which gram-negative bacteria accounted for 69.05% (58/84), fungi 26.19% (22/84), and gram-positive bacteria 4.76% (4/84).The most of them were Acinetobacterbaumannii 27.38% (23/84). Multiple infections were more than the proportion of 48%. Univariate analysis showed that there were 26 statistically significant items (P all < 0.01). Non-conditional binary logistic regression analysis showed that there were 4 independent risk factors with statistical significance: length of ventilator using> 5 days, length of cardiopulmonary ≥2h, perioperative blood transfusion >1 200 ml and perioperative using of acid inhibitors. Conclusions The study showed that most of the predictable VAP factors cannot be artificially intervened. Basing on the occurrence and development of VAP and the status of nursing interventions, Medical staff should take enhanced measures to prevent the occurrence of VAP and improve the quality of medical care

Percutaneous endoscopic gastrostomy (PEG) and percutaneous endoscopic Jejunostomy (PEJ) are common channels for enteral nutrition input. In the past five years, there are no relevant nursing guidelines and reviews in China. In August 2018, Wound, Ostomy and Continence Nurses Society (WOCN) issued the Clinical Practice Guidelines for Nursing Management of Percutaneous Endoscopic Gastrostomy and Jejunostomy in Adults, including preoperative preparation, surgical procedure and postoperative monitoring of gastrostomy and Jejunostomy. The management of enteral nutrition tube, the use of enteral nutrition and drugs, the prevention of medication errors, the treatment of early and late complications, the education of patients and their caregivers, and the replacement of catheters are all recommended. This article interpreted the guideline in order to provide reference for clinical nursing of gastrostomy and Jejunostomy.

Venous thromboembolism(VTE)is an important etiology for unexpected deaths and perioperative deaths of inpatients. Early diagnose and early prevention are main measures to reduce the incidence and mortality of VTE. Herein, we have established a comprehensive management system of VTE prevention, treatment and research. On one hand, we implemented the in-hospital VTE prevention management and improved the implementation status of VTE prevention and treatment. As a result, the number of diagnosed VTE cases and related medical disputes decreased by years. On the other hand, we have built up the VTE monitoring platform, providing useful statistical data for the clinical use of anticoagulants and further reducing the incidence of VTE. The VTE monitoring platform also revealed some significant differences of the VTE incidence between the medical patients and the surgical patients, which could provide reference for further revision of VTE guidelines.

Objective? To explore the clinical application of information technology in the multidisciplinary chain management of surgical patient handover, in order to reduce the safety hazard in the process of surgical patient handover. Methods? In the contemporary controlled study, 300 patients were selected as the control group from February to July 2017 by cluster sampling, and 303 patients were selected as experimental group from February to July 2018. Traditional sectional handover method was adopted in the control group, to managed the patients＇ handover from each section. In the experimental group, based on the information communication platform between the surgery room and relevant clinical departments, by clinical electronic documents chain transfer method, quality inspection and supervision information feedback technology, to achieve shared decision and improvement of patients handover problems, we built the multidisciplinary management pattern. The two groups were compared for statistical difference from six aspects:the rate of acceptance specification, the accuracy of identity verification method, the rate of operation labeling verification, the accuracy of inventory of items, the evaluation of pipeline patency, and the evaluation of skin condition at the compression site. Results? The rate of standard delivery of surgical patient handover increased from 49.33% to 92.08% in the two groups. The experimental group was better than the control group in the rate of correct delivery of handover from the following five aspects: identity recognition, indication of surgical site, inventory of articles carried, unobstructed pipeline and skin state of the pressure site with statistical significance (P＜ 0.01). Conclusions? The multidisciplinary chain management model of surgical patient handover supported by information technology is effective in clinical application, which can significantly reduce the risk of hazard in patient handover and is worthy of clinical promotion.