As a new type of medical service project, "Internet + nursing service" has become a new trend in the development of nursing. Ningbo area started the exploration of "Internet + nursing service" as early as the end of 2015, and gradually formed the Ningbo model of "government-led, regionalized layout, and online and offline collaborative services, medical professional support, market-based operation". And made the innovative practice of "medical insurance pay at home". By the end of December 2021, there were 6 200 registered nurses on the platform, and a total of 20 993 door-to-door services were provided. 197 medical institutions settled on the platform and carried out 49 home service projects. This paper introduced the exploration experience and practical results of "Internet + nursing service" in Ningbo, and provided reference and reference for the advancement of this work.

Objective:To construct the "Internet +" peripherally inserted central catheter (PICC) home nursing service quality evaluation index system, so as to provide objective basis for standardizing the "Internet +" PICC home nursing service quality evaluation.Methods:Based on the three-dimensional quality structure model of "structure-process-outcome", combined with literature research, semi-structured interviews, group discussions and Delphi method, 20 experts who were engaged in intravenous therapy nursing and had management or practical experience in "Internet + nursing services" were selected for two rounds of consultation to determine the "Internet?+" PICC home nursing service quality evaluation index system. The positive coefficient of experts was expressed by the effective response rate of the questionnaire and the rate of expert opinion submission. The degree of expert authority was expressed by the expert authority coefficient. The coordination degree of expert opinions was represented by the Kendall harmony coefficient. The concentration degree of expert opinions was usually expressed in terms of the importance assigned to the indicator, the coefficient of variation, and the full score rate (%) .Results:The effective response rates of the two rounds of consultation questionnaires were all 100%, with expert authority coefficients of 0.793 and 0.848 respectively. The Kendall coordination coefficients of expert opinions were 0.202-0.216 and 0.222-0.270 respectively ( P<0.05). After the second round of expert consultation, the mean importance assigned to all indicators was greater than 4.0, the coefficient of variation was less than 0.2, and the full score rate was greater than 20%. The final "Internet +"PICC home nursing service quality evaluation index system included 3 first-level indicators, 12 second-level indicators and 64 third-level indicators. Conclusions:The "Internet + " PICC home nursing service quality evaluation index system constructed is scientific, reliable and practical, and reflects the specialty characteristics. It can effectively evaluate the "Internet + " PICC home nursing service quality and provide guidance for continuous improvement.

This article reviews the application of patient-reported outcome measures in symptom measurement, quality of life measurement, adverse event reporting and clinical decision-making in breast cancer patients, so as to provide a reference for the application and development of related measures.

Objective:To deeply understand needs and problems of on-site nursing service training for "network nurses", so as to provide a reference for the construction of "Internet + Nursing Service" training content system standards.Methods:Using the purposive sampling method and based on principle of maximum differentiation, a total of 12 "network nurses" in Ningbo were selected from March to May in 2020 to conduct semi-structured interviews. Braun thematic analysis method was used to analyze data and extract themes.Results:A total of 4 themes were obtained. The first was that the requirements of practicing safety education and training included risk prevention training, adverse event handling process training, emergency response plans and complication handling training. The second was the needs of humanistic care education and training, including on-site service language, code of conduct training, nurse-patient communication training and health education knowledge training. The third was the demand for diversified training forms. Fourthly, factors affecting training quality.Conclusions:"Network nurses" have a greater demand for occupational safety education and humanistic care education. It is recommended that multiple parties should cooperate to improve the "Internet +Nursing Service" emergency laws and regulations as soon as possible, provide diversified training models, reserve high-quality "Internet + Nursing Service" talents and promote continuous and standardized development of "Internet + Nursing Service".

Objective:To explore the changing characteristics of self-efficacy, social support, psychological stress in patients with osteoporotic vertebral compression fractures (OVCFs) receiving conservative treatment at different treatment stages and their correlations with the recovery of lower back function.Methods:A total of 116 patients with acute OVCFs who were admitted to the Affiliated Hospital of Medical School, Ningbo University were selected from January 2017 to May 2019. Oswestry Disability Index (ODI) Questionnaire, General Self Efficacy Scale (GSES) , Perceived Social Support Scale (PSSS) and Perceived Stress Scale (PSS) were used to assess the lower back function, self-efficacy, social support and psychological stress of OVCFs patients. Questionnaires were filled out during outpatient reexamination or in-home follow-up, and the evaluation time was at the time of treatment and 1, 3, 6, and 12 months after conservative treatment. Analysis of variance and SNK- q test were used to explore the characteristics of each score over time, and linear regression analysis was used to explore the effects of GSES, PSSS, and PSS on ODI. Results:With the prolongation of treatment time, ODI, GSES, PSSS and PSS scores of OVCFS patients under conservative treatment showed a downward trend, and the scores at 3, 6 and 12 months after treatment were lower than those at 1 month after conservative treatment ( P<0.05) . The scores at 6 and 12 months after conservative treatment were lower than those at 3 months after conservative treatment ( P<0.05) . The scores at 12 months after conservative treatment were lower than that those at 6 months after conservative treatment ( P<0.05) . GSES, PSSS (total score, in-family support, out-of-family support) and PSS were independent influencing factors of ODI at one month after treatment ( P<0.05) . GSES, PSSS (total score, in-family support) and PSS were the influencing factors of ODI at 3 months after treatment ( P<0.05) . Conclusions:The self-efficacy and social support of conservatively treated patients with OVCFs are positively correlated with their lower back function, while psychological stress will reduce lower back function of such patients. It is suggested to add these non-physical factors to the rehabilitation nursing model and take appropriate intervention measures.

Objective:To analyze the real work experience of "online nurses" door-to-door services under the Internet model so as to provide a basis for the government and management departments to carry out "Internet + nursing services" work.Methods:According to the phenomenological research method, intentional sampling and the principle of maximum differentiation were used to select 20 nurses who had provided home care services in Class Ⅲ Grade A hospital and hosted community health service center in Ningbo for the semi-structured interview from August to November 2019. The interview data was organized and analyzed using the Colaizzi data analysis method.Results:There were two themes that affected the work experience of "online nurses" nursing service. Among them, the positive factors included the obvious increase in professional values, policy support guarantee, the surge in patient demand, insurance protection and first aid safety guarantee; the negative factors included the unbalanced input and harvest, service costs not included in medical insurance, improper disposal of medical waste, lack of team support, insufficient publicity of "online" nursing services, weak multidisciplinary nursing knowledge, and lack of standardization of "online" nursing medical records.Conclusions:The "online nurses" have positive experiences such as increased professional values in their service experience. At the same time, there are also difficulties such as imbalance in income and expenditure, and insufficient team support. It is necessary to further strengthen the government-hospital-community-enterprise collaboration, gradually improve the "online" nursing service standards from multiple angles and directions, provide a good working environment and the security for online nurses so as to serve society well.

The " Internet+ Nursing Service" has been explored in localities as a new type of medical service. The paper introduced the innovation and excellence in the operation of Ningbo in the past four years, namely a unified operation platform to save resources, marked-based pricing to care for interests of three parties, nursing qualifications to safeguard quality of service, contracting with hospital entities to clarify responsibilities and rights, government leadership to determine assessment goals, and Ningbo Nursing Association in guidance to ensure homogeneous service. Thanks to the above measures, no disputes and complaints were recorded among 3 088 person-times ever since. Experiences in Ningbo may serve as a reference for such model to be implemented smoothly and orderly in other places.

Objective To explore the work experience and responding measures of the second-line on duty senior nurses in night shift rescue.Methods In-depth interviews were conducted in 11 nurses and the interview data were collected and analyzed by phenomenological research method.Results The work experience of the second-line on duty senior nurses in night shift rescue was divided into three stages and eight topics. Before rescue: the influence of working environment on sleep; concerns over the incompetence of the emergency work because of the unfamiliarity of the specialty; the invisible pressure from their responsibility. During the rescue: the ability of quick adjustment into new environment and rescue state; timely detection and suppression of potential security risks of nursing; the perception of lack of knowledge in night shift nurses and themselves. After the rescue: occupational pride gained from emergency rescue; and the desire for knowledge. Conclusions Nursing managers should pay attention to the work experience of the senior nurses who are on the duty of second-line and take effective interventions to better play the role of senior nurses, at the same time, improve the working ability of night duty nurses to ensure the quality and safety of night nursing work.

Objective To explore the real life experience of family caregivers among mild cognitive impairment (MCI) patients during health care so as to provide a reference for reducing family caregivers burden.Methods From March 2017 to March 2018,we selected 18 family caregivers of community MCI patients in Department of Neurology,rehabilitation and memory outpatient at the Affiliated Hospital of Medical School of Ningbo University as subjects by purposive sampling.Semi-structured interview,a phenomenological approach of qualitative research,was used to collect data,and Colazzi analysis was used to sort out,analyze data and refine theme.Results A total of four themes in real life experience of family caregivers of community MCI patients were extracted including family caregivers lacking knowledge about disease (fear,worry and stigma),family caregivers being with high pressure during health care,compromising and confronting actively,expecting to seek more social supports (eager to learn disease-related knowledge,hope to get relatives' understanding and help,gain community supports and environmental supports).Conclusions Community MCI health care brings negative influences on life of family caregivers.Medical staff,family members and community organization need to provide multi-path support to reduce mental pressure and social economic burden of family caregivers of community MCI patients so as to improve their quality of life.

Objective To investigate inner experience of junior nurses after a serious adverse event.Methods A total of 7 junior nurses undergoing a serious adverse event were interviewed from June to August 2016, using the phenomenological approach in qualitative research. The interview was analyzed by phenomenological methodology. The information was dealt with Colaizz 7 steps analysis method.Results The perception of junior nurses experiencing a serious adverse event could be classified into 3 themes: emotional changes in different periods, family attitude having an impact, the pursuit of nursing work having some changes. Conclusions The interview of junior nurses can help them undergoing a serious adverse event to express inner feelings, which shorten the time of mental health and provide the basis for the research on nursing adverse event management system.