The American Endocrine Society released"Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings:an EAndocrine Society Clinical Practice Guideline"in June 2022,which provides 15 evidence-based recommendations for ten clinical points of hospitalization management for patients with diabetes and/or hyperglycemia.The purpose of this paper is to interpret it,to provide a feasible and safe blood glucose control programs for the management of hyperglycemia in non-severe inpatient adults,and provide guidance for standardizing clinical operation of medical staff,so as to improve patients'poor prog-nosis and improve the quality of life.

Objective:To investigate the current situation and influencing factors of knowledge, attitude and practice in terms of refeeding syndrome (RFS) in enteral nutrition among nurses in intensive care unit (ICU), and to inform the development of relevant training framework.Methods:A total of 1 332 ICU nurses were surveyed using a self-developed questionnaire on knowledge, attitude and practice towards refeeding syndrome in enteral nutrition. The questionnaire consists of 45 items covering three dimensions, namely knowledge, attitude and practice.Results:The subtotal scores of knowledge, attitude and practice were 60.00 (48.00, 66.75), 53.00 (48.00, 60.00) and 46.00 (39.00, 52.00), respectively. The total score was 156.78±23.03. Multiple linear regression analysis showed that the influencing factors for the total score included age, years of working in ICU, professional title, position, specialist nurses or not, experiences of relevant training ( P<0.05). Conclusions:ICU nurses had better attitude towards RFS, but the level of knowledge and practice still need to be improved. Nursing managers should develop and optimize the training system to enhance the knowledge and behavior concerning RFS in ICU nurses, so as to further improve the nursing quality in terms of RFS management.

Objective To develop a Nursing Knowledge-Attitude-Practice Assessment Questionnaire for the Investigation of Enteral Nutrition Refeeding Syndrome and to test its reliability and validity.Methods Based on the theory of knowledge-attitude-practice,an initial questionnaire was developed through literature review,Delphi and pre-survey.350 ICU nurses from 2 tertiary A hospitals in Chongqing were investigated for item analysis,reliability analysis and exploratory factor analysis in August 2023;another 546 ICU nurses were selected for confirmatory factor analysis from 5 tertiary A hospitals.Results The final questionnaire included 3 dimensions and 45 items.The total Cronbach's α coefficient,split-half reliability,test-retest reliability and the questionnaire level content validity index were 0.970,0.878,0.873,and 0.940,respectively.Exploratory factor analysis extracted 3 common factors;the factor load of each item ranged from 0.535 to 0.878;the cumulative variance contribution rate was 68.683％.Confirmatory factor analysis showed that the model fit well and the questionnaire's factor structure was stable.Conclusion The Nursing Knowledge-Attitude-Practice Assessment Questionnaire for the Investigation of Enteral Nutrition Refeeding Syndrome has good reliability and validity,which can be used as a survey tool to evaluate enteral nutrition refeeding syndrome cognitive level of ICU nurses.

Objective:To evaluate the effects of objective feedback teaching applied in the specialist nurses training of digestive endoscopy.Methods:Six-eighty nurses participating in the training of specialist nurses of digestive endoscopy in Chongqing were recruited in the study, among which, 30 trainees in 2019 were assigned to the observation group, taking objective feedback teaching, and 38 trainees in 2018 were assigned to the control group, receiving traditional teaching. After the training, the two teaching methods were assessed through theoretical results, operation skills and comprehensive evaluation, and meanwhile a self-designed satisfaction questionnaire on the satisfaction of trainees was conducted. SPSS 25.0 was used to perform t-test, Chi-square test and Mann-Whitney U test. Results:The operation skills (84.90±4.92) and comprehensive quality (86.30±4.62) of observation group were higher than those of the control group [(82.39±4.10), (83.86±5.10)], with statistically significant differences ( P<0.05), while there was no significant difference in theoretical knowledge [(85.80±5.63) vs. (83.68±4.51), P>0.05]. Trainees were satisfied with the new training mode. Conclusion:The objective feedback teaching mode can improve the training effect especially on operation skills and comprehensive quality of the specialist nurses of digestive endoscopy, and insure the satisfaction of specialist nurses with the training.

Objective:To explore the effect of family integrated care (FIC) combined with intelligent health education platform in health education for elderly patients with stroke.Methods:Eighty patients with stroke were included from the Department of Neurology of the Second Affiliated Hospital of Chongqing Medical University from June 2019 to May 2020. They were divided into the experimental group and the control group ( n=40, respectively) by the random number table method. Patients in the control group received routine FIC in the Department of Neurology. Additional intelligent health education platform was provided for the experimental group to carry out intensive education. The modified Barthel index scale, self-care compliance scale and hospital anxiety and depression scale (HADS) were used before and after the intervention to evaluate patient′s self-care ability, self-care compliance and the degree of anxiety and depression. Results:Finally, 39 patients in the experimental group (1 case lost to followed-up) and 37 patients in the control group (3 cases lost to followed-up) completed the study. After the intervention, the scores of the modified Barthel index and self-care compliance scale of the experimental group were significantly higher than those of the control group [(65.9±12.6) vs (60.1±11.9) points, (78.2±13.6) vs (71.4±14.6) points], the HADS score was significantly lower than the control group [(15.18±2.46) vs (19.46±2.40) points] (all P<0.05). The scores of the modified Barthel index scale and self-care compliance scale of the experimental group after the intervention were significantly higher than those before the intervention [(65.9±12.6) vs (40.8±12.5) points, (78.2±13.6) vs (54.6±15.9) points] (all P<0.05), the HADS score was significantly lower than before the intervention [(15.18±2.46) vs (21.74±3.52) points] (all P<0.05). Similarly,the scores of the modified Barthel index and self-care compliance scale of the control group after the intervention were significantly higher than before the intervention [(60.1±11.9) vs (41.6±9.72) points, (71.4±14.6) vs (54.3±14.8) points], the HADS score was significantly lower than before the intervention [(19.46±2.40) vs (21.38±3.09) points] (all P<0.05). Conclusion:FIC combined with intelligent health education platform can significantly improve the self-care ability and self-nursing compliance of elderly stroke patients, and markedly improve the degree of depression and anxiety.

Objective: To explore the effect of combining graduate education of Master of Nursing Specialist with standardized training in a college in Chongqing. Methods: Cluster sampling was used to select 25 of the class of 2015 nursing degree graduates who had participated in the standardized training of nurses, and 18 of the class of 2018 nursing degree graduates who had not participated in the standardized training of nurses. The core competencies of nurses for the grade 2015 and 2018 was investigated. In addition, the satisfaction of grade 2015 students was investigated, and the training effect and existing problems of the "Double Track In One" clinical practice training mode were analyzed in combination with the standardized training results of nurses.At the same time, the "Double Track In One" clinical practice training mode was described. Results: The total score of the core competence of nurses of grade 2015 was 108.40±20.47, and the total score of the core competence of nurses of grade 2018 was 128.68±26.83. The score of the students of grade 2015 was higher than that of the students of grade 2018 in clinical ability, critical thinking and scientific research ability, interpersonal relationship, leadership, ethics and legal practice, and the difference was statistically significant (t=-3.05, P < 0.05). The total score of the satisfaction survey was 88.12±12.44, which was at a medium level. Conclusion Chongqing Medical University has conducted the clinical practice training of "Double Track In One" for Master of Nursing Specialist, which has achieved good results and effectively improved the core competence of nurses for nursing graduate students, providing a good reference for further promoting the link between nursing graduate education and professional qualification.

Objective To establish a systematic and scientific transitional care quality evaluation index for patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI), and to determine the weight of the index.Methods Using self management theory and Omaha effectiveness evaluation system as frameworks, the transitional care quality evaluation index for patients with CHD after PCI was basically formed on the basis of literature analysis and qualitative research. Totally 23 experts were consulted by Delphi method, and the weight of each index was determined by analytic hierarchy process (AHP).Results The quality evaluation index was finally determined after three rounds of expert consultation, composing of 4 first-class indexes, 16 second-class indexes and 42 third-class indexes. The questionnaire recovery rates of the three rounds of consultations were 91.3％, 81.0％ and 100.0％ respectively. And the authority coefficient of the experts were 0.87, 0.88 and 0.91 respectively. The index weight of various levels were determined by AHP. The weight of 4 first-class indexes were 0.489, 0.137, 0.304 and 0.070 respectively, and theCr value of indexes of various levels were all less than 0.10.Conclusions The transitional care quality evaluation index for patients with CHD after PCI is established to give feedback on the effects of transitional nursing and to promote the quality of transitional nursing.

Objective To develop an instrument for measuring family relocation stress scale during patient transferred from ICU. And to provide evidence for ICU health care personnel to assess and deal with the family member′s relocation stress. Methods A draft scale was developed based on the result of related scale abroad, literature review and semi-structured interviews. Delphi method and Classical test theory were used in item selection. Results The degree of experts′ authority in two rounds′consultation were 0.83. The Kendall′s coordination coefficients of importance were 0.36, 0.36 (P<0.05) in dimension and 0.35, 0.37 (P<0.05) in item. Five items were deleted by the statistical analysis with pilot investigation. 6 dimensions (transfer anxiety, environmental changes, disease severity, nursing model changes, the safety of transfer, self-efficacy of care ability) and 20 items consisted the scale. The Cronbach α coefficient was 0.882. Exploratory factor analysis extracted 6 items, accumulated variance contribution rate was 72.226%. Confirmative factor analysis showed χ2/df=1.677, comparative fit index=0.936, Tucker-Lewis index=0.921, root mean square error of approximation=0.061. Conclusions The scale is based on abundant theoretical evidence and reasonable design, with satisfactory reliability and validity. It can be used as the evaluation tool for family relocation stress during patient transferred from ICU.

Objective To construct nursing service quality evaluation index system for abdominal operation patients. Methods Based on the service quality(SERVQUAL)model, a total of 33 nursing experts were selected by Delphi method for two turns of consultation. All the consultation experts have got senior professional title and 90.9%(30/33) have been working for more than 20 years. Finally, we calculated the questionnaire response rates, the authority coefficient, the mean and standard deviation, the coefficient of variation and the harmony coefficient. Results The response rates of questionnaires was 91.89% and 100% respectively, while the authority coefficient of experts was 0.91. The harmony coefficient of first and second and third indictors was 0.43, 0.47 and 0.53 respectively in the second consultation. Combined with selection of indicators and expert opinion, the final evaluation index system includes 6 first grade indexes, 14 second grade indexes and 49 third grade indexes. Conclusions There is a high level of authority and team coordination in experts. The results of the study can provide a reference for evaluating the nursing service quality of abdominal operation patients.

Objective To investigate the clinical application of the emergency triage criteria in the Hospital Emergency De‐partment Standardization Process by comparing it with the 5 level national triage system (5L NTS) .Methods Totally 984 patients visiting the emergency department of the Wushan County People′s Hospital from January 1 to January 31 ,2015 were chosen to con‐duct the evaluation of 4‐grade classification standard triage with 5L NTS as the control evaluation criteria .The error rate ,evaluation time and degree of difficulty or ease were compared between the two criteria .Results The error rate of 4‐grade triage standard was 4 .7% ,which of 5L NTS was 3 .6% ,the difference was not statistically significant (χ2 =1 .220 ,P=0 .269) .The triage time had sta‐tistical difference between the two criteria (t= -2 .291 ,P=0 .04) ,while the degree of difficulty or ease in using criteria had no sta‐tistical difference(χ2 =1 .143 ,P=0 .285) .Conclusion The 4‐grade triage criteria recommended by the Hospital Emergency Depart‐ment Standardization Process has no obvious differences in the aspects of triage error rate ,degree of difficulty or ease in use com‐pared with the widely recognized 5L NTS in the world ,and has the clinical promotion value .