Objective To explore the growth of psychiatric nurses after experiencing traumatic event during the night shifts,in order to provide targeted interventions and guidance for them at different stages,and to provide training directions for newly graduated nurses by managers or interveners. Methods 12 psychiatric nurses who experienced traumatic events during the night shifts in a tertiary hospital in Guangdong Province from March to July 2020 were interviewed by grounded theory method. Based on Strauss and Corbin grounded theories,open login,axial login and selective login were conducted for continuous comparison and analysis for data. Results This study found that psychiatric nurses experienced 3 different stages after experiencing night shift traumatic event,including stress period,adjustment period,and growth period. Conclusion The growth of psychiatric nurses after night shift traumatic event is a dynamic process. Managers or interveners can carry out targeted interventions and guidance according to different stages,and encourage them to prepare relevant knowledge and skills in advance during the early training of newly graduated nurses.

Objective To summarize the best evidence of sputum collection methods for patients with pulmonary tuberculosis. Methods We searched websites and databases including, but not limited to, BMJ best practice, UpToDate, World Health Organization, Registered Nurses’ Association of Ontario, National Institute for Health and Care Excellence, Guidelines International Network, Infectious Diseases Society of America,Cochrane Library,CINAHL（EBSCO）, EMBASE（OVID）, PubMed, Web of Science, JBI, CNKI, Wanfang, VIP, and CBM. Guidelines,recommended practices,evidence summaries,expert consensuses, and systematic reviews regarding collection methods of sputum samples for patients with pulmonary were considered. 2 researchers independently assessed methodological quality of included papers and extracted data. Results A total of 13 papers were identified including 6 guidelines, 3 systematic reviews,and 4 expert consensuses. 24 pieces of evidence were categorized into 6 aspects including pre-collection evaluation,pre-collection intervention,collection methods,sputum sample evaluation and transportation,occupational protection, and patient education. Conclusion This evidence summary provided sufficient evidence-based information for healthcare professionals to conduct sputum specimen collection for patients with pulmonary tuberculosis. Healthcare professionals should also consider feasibility, appropriateness, meaningfulness, and effectiveness of evidence in local context before adopting a certain method of sputum collection.

Objective To investigate the effect of sequential sputum excretion scheme on pulmonary tuberculosis patients treated with mechanical ventilation. Methods Forty-five pulmonary tuberculosis patients with mechanical ventilation were selected as the experimental group from January to December 2018,and received sequential sputum excretion scheme;while 44 patients were recruited as the control group from January to December 2017 receiving routine sputum management. Breathing rate,mean arterial pressure,blood oxygen saturation,arterial oxygen partial pressure,artery oxygenation index,CO ₂ partial pressure,airway peak pressure value,the amount of sputum drainage,effect of sputum excretion,incidence of ventilator-associated pneumonia,length of mechanical ventilation,length of ICU stay,and success rate of ventilator weaning were compared between two groups. Results After 24 hours of intervention,there was significant difference in breathing rate and no significant difference in mean arterial pressure fluctuation before intervention in two groups,but blood oxygen saturation,arterial oxygen partial pressure and oxygenation index in the experimental group were higher than those in the control group and before intervention（ P<0.05）. After intervention,the peak airway pressure and arterial CO ₂ partial pressure in the experimental group were significantly lower than those in the control group and before intervention（ P<0.05）. After 24 hours of intervention,the daily sputum excretion in the experimental group（29.48±4.54） ml was significantly higher than the control group（12.56±2.287） ml（ P<0.001）. After 7 days of intervention,the effect of sputum excretion in the experimental group was better than the control group（ P<0.05）. Compared with the control group,the incidence of ventilator-associated pneumonia,the length of mechanical ventilation and the length of ICU stay in the experimental group were lower and shorter,and the success rate of ventilator weaning was higher（ P<0.05）. Conclusion Sequential sputum excretion scheme can promote the discharge of sputum in pulmonary tuberculosis patients with mechanical ventilation,improve pulmonary function and quality of life,shorten length of stay in ICU and reduce medical burden.