Objective To explore the application of nurse-performed point-of-care ultrasound in abdominal distension of ICU patients with enteral nutrition.Methods Purposive sampling method was used to select 108 patients with enteral nutrition abdominal distension admitted to the ICU of a tertiary A general hospital in Hefei City from January to December 2022,and they were divided into an experimental group and a control group according to random number table method.The experimental group used bedside ultrasound to evaluate the stomach,intestine and abdominal cavity of patients with abdominal distension,and implemented targeted treatment measures according to the evaluation results.The control group was given corresponding treatment measures according to the abdominal sight,touch,tapping,listening and traditional syringe withdrawal method.Intra-abdominal pressure,abdominal circumference,feeding compliance rate and feeding interruption rate,ICU stay time and mechanical ventilation time were compared at the 1st,3rd and 5th day.Results 11 cases dropped out of the study due to transfer,automatic discharge,death,etc.,and 97 cases were included 51 cases in the experimental group and 46 cases in the control group.Repeated measurement ANOVA showed that intra-abdominal pressure and abdominal circumference time in the 2 groups had interaction with each other(F=41.724,P＜0.001;F=17.762,P＜0.001).Generalised estimating equations showed that there was only a between-group effect for the rates of feeding compliance and feeding disruption in 2 groups(Wald y2=18.033,P＜0.001;Wald x2=6.567,P＜0.001).Simple effect analysis showed that on the 3rd and 5th day after intervention.The experimental group had lower abdominal depression and the feeding interruption rate was lower than the control group(P＜0.05).On the 5th day after interven-tion,the abdominal circumference of the experimental group was lower than that of the control group,the feeding compliance rate was higher than that of control group(P＜0.05).After intervention,in the experimental group,the mechanical ventilation time was shorter than that of the control group(P＜0.05).There was no significant difference in ICU stay time between the 2 groups(P=0.095).Conclusion The application of nurse-performed point-of-care ultrasound in the management of abdominal distension in patients with enteral nutrition in ICU is feasible and scientific,which is helpful for the management of patients with enteral nutrition abdominal distension in ICU,reducing internal abdominal pressure,shortening mechanical ventilation time,and avoiding the occurrence of feeding intolerance.

Objective:To design an assisted lip retraction breathing exercise tool and observe its application in home-based pulmonary rehabilitation of patients with chronic obstructive pulmonary disease(COPD). Method:A total of 116 COPD patients treated at our hospital from January 2020 to January 2021 were select-ed as study subjects and divided into the control group(n=58)and the observation group(n=58)using a ran-dom number table method.The control group was given conventional inhalation medication and lip retraction breathing training instruction,and the observation group was given an assisted lip retraction breathing exercise tool to assist lip retraction training on the basis of the control group.The pulmonary function,arterial blood gas,6-minute walk distance(6MWD),modified British medical research council(mMRC),body mass in-dex,obstruction,dyspnea,exercise capacity index(BODE index)and patient satisfaction were compared be-tween the two groups at l month,3 months,and 6 months after discharge from the hospital. Result:After 3 and 6 months of exercise,the pulmonary function(FVC,FEV1)of the observation group were better than those of the control group(t=2.196,2.613,3.022,4.200 P＜0.05),and arterial blood gas(PaCO2,PaO2)were better than the control group(t=5.223、11.536、2.086、2.223 P＜0.05),6MWD was higher than the control group(t=10.725,11.620 P＜0.05),mMRC was lower than the control group(t=10.110,22.567 P＜0.05),BODE index grade 1(17.24％,34.48％)and grade 2 rates(37.93％,48.28％)were higher than the control group(10.34％,6.90％,25.86％,27.59％),and grade 3(25.86％,17.24％)and grade 4 rates(18.97％,0)were lower than the control group(31.03％,34.48％,32.76％,31.03％)(Z=-2.060,35.273 P＜0.05),the satisfaction rate of patients in the observation group was 91.38％(53/58)at 1 month of exercise,96.55％(56/58)at 3 months,and 100％(58/58)at 6 months. Conclusion:The assisted lip retraction breathing exercise tool can improve the home-based pulmonary rehabilita-tion,enhance exercise endurance,reduce the severity of dyspnea,and improve patient satisfaction.

Objective:To explore the current status of vicarious posttraumatic growth (VPTG) among emergency nurses, and analyze its influencing factors and pathways of action.Methods:From March to May 2022, convenience sampling was used to select 532 emergency nurses from 20 public general hospitals in Anhui Province as the research subject. A survey was conducted on emergency nurses using the General Information Questionnaire, Posttraumatic Growth Inventory, Chinese Version of the Interpersonal Reactivity Index, Connor-Davidson Resilience Scale, and the Multidimensional Scale of Perceived Social Support. AMOS 24.0 software was used to establish the structural equation model and analyze the path relationships between variables.Results:A total of 532 questionnaires were distributed, and 480 valid questionnaires were collected, with an effective response rate of 90.23% (480/532). The score of the Posttraumatic Growth Inventory for 480 emergency nurses was (49.35±15.82). Empathy, psychological resilience, and perceived social support all had a positive impact on VPTG, with total effect values of 0.503, 0.261, and 0.163, respectively. Empathy directly or indirectly affected VPTG through perceived social support and psychological resilience. Perceived social support indirectly affected VPTG through psychological resilience, and psychological resilience directly affected VPTG.Conclusions:VPTG of emergency nurses is directly and/or indirectly positively influenced by empathy, psychological resilience, and perceived social support. Nursing managers should pay attention to the interaction between factors, take effective measures based on the association between factors, and promote the positive transformation of emergency nurses after trauma.

Objective:To observe the application effect of a self-designed assisted abdominal breathing rehabilitation device in elderly patients undergoing postoperative chemotherapy for lung cancer.Methods:Self-designed an assisted abdominal breathing rehabilitation device. Used the convenience sampling method, 116 elderly patients admitted to the First Affiliated Hospital of Anhui Medical University from April 2021 to April 2022 undergoing postoperative chemotherapy for lung cancer were selected as study subjects, and they were divided into control and observation groups by the random number table method, with 58 cases in each group. The control group received routine abdominal breathing training, and the observation group used auxiliary abdominal breathing rehabilitation device for abdominal breathing training, and compared the training compliance rate, lung function indexes and six minutes-walk test scores of the two groups before and after 2 weeks of training.Results:After 2 weeks of training, the training compliance rate of patients in the observation group was 100.00% (58/58), which was higher than 87.93% (51/58) in the control group, and the difference was statistically significant ( χ 2=7.45, P<0.05). After 2 weeks of training, FEV 1, FVC, FEV 1/FVC were (1.81 ± 0.29) L, (1.98 ± 0.32) L, (91.91 ± 5.98) % respectively in the observation group, and (1.49 ± 0.31) L, (1.73 ± 0.41) L, (87.11 ± 9.44) % respectively in the control group, there were statistically significant differences between the two groups ( t=-4.13, -2.60, -2.36, all P<0.05). After 2 weeks of training, the six minutes-walk test score was (0.86 ± 0.71) points in the observation group and (1.02 ± 0.74) points in the control group, and the difference was statistically significant ( t=2.05, P<0.05). Conclusions:An assisted abdominal breathing rehabilitation device helps to improve the training compliance rate, enhance lung function recovery and improve exercise endurance in elderly patients undergoing chemotherapy after lung cancer surgery.

Objective:To investigate the latent classes and influencing factors of vicarious posttraumatic growth among emergency nurses.Methods:Convenience sampling method was used to select the 498 emergency nurses of 20 public general hospitals in Anhui province as the survey objects. The general information questionnaire and Posttraumatic Growth Inventory were used to investigate. Latent class analysis was used to classify vicarious posttraumatic growth of emergency nurses, and the influencing factors of latent classes were analyzed by binary logistic regression.Results:There were two latent classes of vicarious posttraumatic growth of emergency nurses including high growth-high fluctuation group (24.1%, 120/498) and low growth group (75.9%, 378/498). Binary logistic regression analysis showed that professional title, average monthly income and self-rated health status were the factors influencing the latent classes (all P<0.05). Conclusions:There are obvious classification characteristics of vicarious posttraumatic growth among emergency nurses. Nursing managers should formulate and implement targeted intervention measures according to the classification characteristics and influencing factors to improve their vicarious posttraumatic growth level.

Frailty and trauma are closely related, and together affect the health outcomes of elderly trauma patients. However, insufficient attention has been paid to the frailty of elderly trauma patients in China. This paper reviews the relationship between frailty and trauma, assessment tools and management of frailty in elderly trauma patients, in order to provide a new perspective of nursing care for elderly trauma patients in China and to provide references for carrying out research on frailty in elderly trauma patients.

Objective:To summarize the relevant evidence of environmental management for preventing delirium in ICU patients, so as to provide references for delirium management in ICU patients.Methods:Evidence-based questions were constructed according to the PIPOST model, and relevant clinical decisions, guidelines, expert consensus, systematic reviews and evidence summaries published by various guideline websites, evidence-based databases and comprehensive databases at home and abroad were systematically searched according to the evidence resource "6S" model. The search period was from the establishment of databases to September 3, 2022. Two researchers independently conducted literature quality evaluation using corresponding literature quality evaluation tools. The Joanna Briggs Institute (JBI) Evidence Pre-grading and Evidence Recommendation Grading System (2014 Edition) was used to grade and recommend included evidence.Results:A total of 30 articles were included, including 5 guidelines, 2 expert consensus, 1 clinical recommended practice, 4 evidence summaries and 18 systematic reviews. A total of 36 best evidences were summarized from 5 aspects, including environment optimization, sleep promotion, cognitive stimulation, positioning and orientation function, and safety protection.Conclusions:Medical staff should manage the ICU environment based on evidence-based evidence to prevent or reduce the occurrence of delirium in patients.

Objective To analyze the current status and influencing factors of job competence of clinical nursing teachers. Methods A total of 673 clinical nursing teachers from 35 second-level and above hospitals in Anhui Province were selected as research subjects using convenient sampling method. Their job competence was evaluated using the Clinical Nursing Teacher Post Competency Evaluation Scale. Results The score of job competence of clinical nursing teachers was 87.1±9.7. The results of multiple linear regression analysis showed that with the increase of service length and clinical teaching years，the job competence score of clinical nursing teachers increased（all P<0.05）. For those who thought the higher the satisfaction with the teaching atmosphere of the hospital，the hospital teaching training can meet their requirements and the higher the willingness to accept the teaching training，the higher their job competence score（all P<0.05）. Conclusion There is still much room for improvement in job competence of clinical nursing teachers in Anhui Province. The length of service，clinical teaching years， hospital teaching atmosphere，teaching training meeting demand，and willingness to accept clinical teaching training are the influencing factors of job competence of clinical nursing teachers.

OBJECTIVE: To analyze the current status of core emergency response capability of nurses for systematically managing coronavirus disease(COVID-19) in intensive care units and to explore the related influencing factors. METHODS: A total of 100 nurses who systematically manage COVID-19 in the intensive care units from a class 3 grade A hospital in Wuhan City were selected as study subjects by convenience sampling method. The self-designed COVID-19 Core Emergency Response Capability Questionnaire for Nurses was used to investigate the status of COVID-19 core emergency response capability. RESULTS: The total score of the core emergency capability of the nurses averaged 133.1±18.1, and the scoring rate was 80.7%, which was at a high level. The scoring rates of each dimension from high to low were prevention ability, rescue ability and preparation ability, with the score rate of 85.2%, 81.7% and 71.0% respectively. The results of generalized linear regression analysis showed that the level of core emergency response capability of nurses was higher in high-risk departments such as respiratory department, infectious department, intensive care unit, outpatient department and emergency department than that of low-risk departments [partial regression coefficient(β) =11.18, P<0.01]. The levels of core emergency response capability of nurses who were married, once worked in the fever clinic, and were members of the National Health Emergency Rescue Team was higher(β were 8.28, 24.34 and 10.89, respectively, P<0.05). CONCLUSION: The core emergency response capability of nurses who systematically manage COVID-19 in the critical care units in Wuhan City is at a high level. Their core emergency response capability is affected by factors such as personal work experience, marital status, emergency work experience and trainings.

Objective: To explore the quality management of critical patients in the process of medical helicopter rescue and transshipment. Methods: After receiving the rescue and transshipment task for 10 critically ill patients, the Emergency Department quickly established the rescue quality management team under the direction of the dean: with helicopter on-site rescue and transshipment team, in-hospital pick-up and transshipment team, logistic support team and coordination command group; full medical security assessment: to prepare all emergency supplies, drugs, instruments and equipment in a predictable manner, and all within the effective period, completed. The success rate is 100%. The formulation of rescue plan: formulating individualized emergency plan, pre-examination and triage evaluation plan, transporting and implementing process plan; unblocked green channel: setting up rescue room as rescue preparation area; radiology department, laboratory department, pharmacy, B-ultrasound room, electrocardiogram room, emergency transfer elevator, medical housekeeper and other departments ensure the green channel unblocked, safety logistic support team dedicated personnel management. To manage the area from apron to emergency hall and rescue room, smooth transit routes, and prepare for emergency treatment in emergency intensive care unit and specialized intensive care unit. Specialized organizations are responsible for: Department directors, head nurses and quality control team leaders to organize and coordinate quality management work. Results: All 10 critically ill patients were safely and smoothly transported to hospital for emergency treatment without any adverse events. Six patients received emergency intensive care, three orthopaedic care, one hand-foot surgery care, and 10 critically ill patients were discharged from hospital in time and safely through various specialties. Conclusion The successful rescue and safe transshipment of 10 critically ill patients reflects the good beginning of the development of medical helicopter rescue in our province, and forms a complete, organized, targeted, planned and implemented team rescue system, which greatly improves the quality management level of medical helicopter rescue and transshipment.