Objective To develop an evidence-based practice program for ICU eye care and evaluate its application effect using Stetler model of research utilization. Methods The systematic search was carried out in domestic and foreign guidelines，systematic reviews，evidence summaries，expert consensuses on eye care for ICU patients. The quality of the included literature was evaluated and the evidence was summarized. The evidence based on expert advice，clinical context and stakeholder opinions was screened. According to Stetler model of research utilization，the evidence translation/application was formulated from 3 aspects，including method，level and type of evidence application，and the evidence translation was implemented using a stepwise trial design. Five ICUs in a tertiary hospital in Zhejiang Province were selected，and the order of enrollment of each ICU was determined by computer-generated random numbers from April to september，2022. In the first month，all ICUs were in pre-evidence-based practice period，and in the second month，an ICU was trained and entered the evidence-based practice period. Until the 6th month，all ICUs entered the evidence-based practice period. Then the rate of ocular symptoms and implementation rate of eye care measures were compared before and after EBP. Results A total of 1 540 patients were included. With regard to the implementation rate of eye care measures，the rate of lubricant use and suspected ocular infection management in patients at high risk for ocular complications in evidence-based practice period was significantly higher compared with pre-evidence-based practice period（P<0.001），and no statistically significant difference was found in the rate of eyelid closure. The incidence of conjunctival exposure，subconjunctival hemorrhage，conjunctival congestion，and ocular discharge in non-neurology critical care patients decreased compared with pre-evidence-based practice period（P<0.05），and the incidence of conjunctival edema and conjunctival congestion in NICU patients decreased compared with pre-evidence-based practice period as the intervention continued（P<0.001）. Conclusion Evidence-based practice in eye care for ICU patients using Stetler model of research utilization can standardize the practice of eye care for ICU patients and improve the quality of care.

Objective To construct a management scheme of nursing assistants in unaccompanied hospitals and explore its application effect. Methods The management team of nursing assistants in unaccompanied hospitals was set up. On the basis of investigating the current situation of nursing assistants’ team management，the management scheme of nursing assistants was constructed by ORTCC management model for references，including 5 parts：determining management objectives，perfecting rules system，building hierarchical training system，checking and assessing，and shaping cultural system. Convenience sampling method was used to select 92 nursing assistants in an unaccompanied hospital in Xiamen，Fujian Province from June 2021 to June 2022 as application subjects. The post competence of nursing assistants and the satisfaction of patients and nurses to nursing assistants were compared before the application of the management scheme（June-December 2021） and after the application（January 2022-June 2022）. Results After the application of ORTCC management model，the total score of post competency of medical nursing assistants increased from[65（64，67）] to [91（90，92）]；the excellent rate of post competency level increased from 1.09% to 67.39%；the satisfaction of patients with nursing assistants increased from 61.99% to 88.62%；the scores of nurses’ satisfaction with nursing assistants in all dimensions were significantly higher than before（all P<0.05），and the overall evaluation was improved from 92.73% to 99.24%. Conclusion The use of the ORTCC management model for nursing assistants can effectively improve their post competence，improve the satisfaction of patients and nurses，and help to further stabilize and develop the medical nursing assistants staff.

Objective To summarize the best evidence of airway obstruction prevention and management in patients undergoing cervical spinal surgery，and to apply evidence-based nursing practice and evaluate the effects. Methods The best evidence for prevention and management of airway obstruction in patients undergoing cervical surgery was summarized using an evidence-based care approach，and an evidence-based practice protocol was developed. The best evidence application strategy was constructed after baseline review and analysis of barriers，and it was implemented in the department of orthopedics in a tertiary hospital in Hubei Province from August 2020 to December 2021. The knowledge level of nurses about airway obstruction and the implementation rate of the reviewed indicators were compared before and after the application of evidence. Results After the application of best evidence, the implementation rate of 19 review indicators out of 23 significantly improved compared with baseline review（P<0.05）. The score of nurses’ knowledge level of airway obstruction after cervical spine surgery increased from（48.38±9.40） to （53.49±9.67），with a statistically significant difference（P<0.001）. Conclusion The application of the best evidence for prevention and management of airway obstruction after cervical spine surgery can improve nurses’ implementation rate，improve their knowledge level，and ensure patient safety.

To conclude the nursing experience of a case of pregnancy with myasthenia gravis pre-crisis state. Main nursing points include：to strengthen the observation，early identification of myasthenia before crisis state，to strengthen incentive care for the prevention of myasthenia crisis；to conduct phased implementation of respiratory rehabilitation nursing；to strengthen health guidance to prevent disease recurrence. The patient was hospitalized for 29 days，with no occurrence of myasthenia crisis. The dyspnea was significantly improved，and the patient recovered and was discharged.

Objective To evaluate the application of "Internet+" early rehabilitation training in high-risk patients with exercise rehabilitation after percutaneous coronary intervention（PCI），and to evaluate its effect. Methods The convenience sampling method was employed to choose PCI patients at high risk of postoperative exercise rehabilitation as the research subjects from the cardiology department of a tertiary A hospital in Zhejiang province，among which 30 cases in March to April，2022 were allocated into the experimental group. The research team formulated and implemented the “Internet+” platform combined with the early rehabilitation training program based on the standard theory through literature review and expert meetings. 30 patients admitted from January to February 2022，were allocated into the control group，and they received routine offline cardiac rehabilitation training. The compliance of offline rehabilitation training，the incidence of adverse events and quality of life in the process of rehabilitation training were compared between the 2 groups after intervention，and the online reading compliance and satisfaction with the use of “Internet+” rehabilitation training platform in the experimental group were evaluated. Results There were 2 cases dropped out from the experimental group，and 4 cases from the control group，and finally there were 28 cases in the experimental group and 26 cases in the control group. After 7 days of intervention，the offline compliance of the experimental group was higher than that of the control group，and the difference was statistically significant（P<0.001）. There was no significant difference in the incidence of adverse events and quality of life between the 2 groups during rehabilitation training（P>0.05）. In the experimental group，the total reading volume of the online platform was 875 times；the total number of articles was 326 times；the active number was 369 times. The reading rate of the patients was 88.35%；the reading time was 14.8 minutes. The overall satisfaction of cardiology nurses and patients in the experimental group with the online platform was（2.69±0.47），（2.79±0.42）points，respectively. Conclusion “Internet +” early rehabilitation training can effectively im-prove the rehabilitation compliance and quality of life of high-risk patients with postoperative exercise rehabilitation after PCI.

Objective To search，summarize and evaluate the best evidence of exercise training in patients with peripheral arterial disease（PAD），which could further provide evidence-based medical bases for clinical exercise training intervention in patients with PAD. Methods All evidence on exercise training in patients with PAD were retrieved from UpToDate，Society for Vascular Surgery（SVS） website，European Society for Vascular Surgery（ESVS） website，Cochrane Library，PubMed，Springer Link，Embase，Cumulative Index to Nursing and Allied Health Literature（CINAHL），Med-live website，Chinese Society of Vascular Surgery，the Chao-Xing journal database，China National Knowledge Infrastructure（CNKI），Wan-Fang database，and other Chinese and foreign technological journal databases. Evidence was obtained from guidelines，clinical decisions，expert consensuses，evidence summaries，systematic evaluation，and meta-analysis. The retrieval time limit was from the establishment of databases until July 1，2021. There were 2 researchers who evaluated the literature quality and extracted the data. Results A total of 14 articles were included in the present analysis. A total of 20 pieces of best evidence were extracted from 7 aspects，including exercise safety，exercise timing，exercise mode，exercise intensity，exercise time，effect evaluation，and tips. Conclusion The exercise training could improve the walking ability and the quality of life of PAD patients. Thereby，it is recommended that exercise training intervention should be conducted while ensuring safety. The evidence summary process of this study is rigorous and comprehensive. In clinical practice，the medical staff should consider the actual application environment and individual situation of patients when using the evidence.

Objective To construct a scientific and practical training system for cardiac rehabilitation nurses,and to provide references for the training of cardiac rehabilitation nursing talents. Methods Based on Taylor’s model,the training system of cardiac rehabilitation nurses was preliminarily drawn up based on literature review and focus group discussion. Delphi expert inquiry method was used to conduct 2 rounds of expert inquiry by 20 experts in the field. Results The effective recovery rate of 2 rounds of expert letter inquiries was 100%,and the authoritative coefficient of the second round of letter inquiries to experts was 0.925. The final established cardiac rehabilitation nurse training system includes 4 parts,namely training objectives,training content,training management,and assessment and evaluation. Among them,training objectives include 3 first-level indicators and 22 second-level indicators;training content includes 15 first-level indicators and 73 second-level indicators;training management includes 6 first-level indicators and 11 second-level indicators;assessment and evaluation include 3 first-level indicators and 10 second-level indicators. Conclusion The construction process of cardiac rehabilitation nurses training system is scientific and reasonable,which can provide references for cardiac rehabilitation nurse training.

Objective To investigate the current situation of implant use and management in 1225 hospitals in China,and to analyze the existing problems,so as to provide references for the standard management of perioperative implants,and lay a research foundation for the formulation of relevant standards. Methods In May 2021,stratified sampling method was adopted to select operating room management personnel from 1225 hospitals in China. The persons in charge were set in the provinces,autonomous regions and municipalities directly under the central government. All the persons in charge were members of the surgical equipment and materials professional group of Nursing Equipment and Materials Branch of China Medical Equipment Association. Questionnaires were made through the Questionnaire Star and distributed and collected through the WeChat group. A self-designed questionnaire was used,including general information and “Questionnaire on Current Situation of Use and Management of Perioperative Implants”. Results In terms of implant management mode,there were mainly 3 modes,namely three-level management of the equipment department,operating room and specialist group（72.73%）,on-board management of the equipment department（12.24%）,and self-management of the clinical use department（10.69%）. There were great differences among different types of hospitals. In terms of receiving foreign devices and implants,there are still some problems,such as late delivery of suppliers and non-standard charges. In terms of implant traceability management,68.90% introduced an information system to trace the use of implants;62.29% carried out information traceability of the cleaning,disinfection and sterilization process of foreign instruments and implants;48.89% carried out scanning charge and traceability management of implants,indicating that information construction needs to be strengthened. In addition,there are many problems and safety risks in the treatment of unused implants after removal or unpacking and related training,which need to be improved. Conclusion Relevant departments and managers should improve the relevant system and process management according to the scale and actual conditions of different hospitals,strengthen the supervision of implant access,and the whole process information tracing management. Relevant standards should be established in time for non-use of implants after removal and unpacking,so as to fill the management gaps. Supervision over the implementation of existing standards should be strengthened.

Objective An early motor rehabilitation nursing program for stroke patients based on Modified Barthel Index（MBI） grading was constructed to guide clinical nurses to perform precise early motor rehabilitation for stroke patients,in order to provide a basis for developing guidelines for rehabilitation nursing care of stroke patients.Methods Based on literature review and expert meetings,a draft of motor rehabilitation nursing program for stroke patients was constructed. The Delphi method was used to conduct 2 rounds of expert consultations to determine the early rehabilitation nursing program for stroke patients.Results In the first round,17 experts were consulted,and the response rate was 94.12%;in the second round,16 experts were consulted,and the response rate was 100%. The expert authority coefficient was 0.90. After 2 rounds,the coefficient of variation of items was 0 to 0.24,Kendall’s coefficient was 0.226（P<0.001） and the importance value was 4.13 to 5.00. Finally,an early motor rehabilitation nursing program classified by MBI was formed,including 5 first-level indicators（fully dependent,heavily dependent,moderately dependent,mildly dependent and basic self-care） and 47 second-level indicators（rehabilitation）.Conclusion The nursing program constructed in this study is reliable and scientific,and it can provide references for the research and practice of rehabilitation training for stroke patients.