Objective To develop an evidence-based decision support system for nutritional risk screening and assessment in children with congenital heart disease（CHD），and to evaluate its clinical effect. Methods The best evidence for nutritional risk screening and assessment in CHD children was summarized，and an evidence-based decision support system was developed. A before-and-after study design was adopted，and the medical staff and children with CHD admitted to the Cardiac Intensive Care Unit of a tertiary A-level hospital for children in Shanghai were selected as the research subjects. The data of the experimental group was collected from September to December 2021，while the data of the control group was collected from September to December 2020. The outcome measurement were the consistency of nutritional risk screening results of the responsible nurses and nutrition specialist nurses，the time-consuming of nutritional risk screening，the proportion of children receiving nutritional assessment and intervention，the response time of high-risk warning value of nutritional screening，and the satisfaction of medical staff with the use of information system. Results 191 children were included in the experimental group，and 193 were in the control group. The consistency coefficient of the nutritional risk screening results was 0.890 in the experimental group，and it was 0.689 in the control group. The nutritional risk screening time was（2.97±1.05） min in the experimental group，and it was（4.05±1.01） min in the control group. The proportion of infants who received nutritional assessment in the experimental group was 95.29%，compared with 89.64% in the control group；the proportion of infants receiving nutritional intervention was 69.11% in the experimental group，and 54.92% in the control group. The response time of the high-risk warning value of nutritional screening in the experimental group was（4.73±2.31） min，while the control group was（41.53±9.13） min. The satisfaction score of medical staff on the use of the clinical nursing information system was（108.04±11.31） points，and it was（92.89±9.37） points in the control group. The above data were compared between the 2 groups，and all the difference were statistically significant（P<0.05）. Conclusion Using the evidence-based decision support system for nutritional risk screening and assessment of CHD children can improve the consistency of nutritional risk screening results，shorten the time-consuming of nutritional risk screening，promote nutritional assessment and nutritional intervention by medical staff，and improve satisfaction with the use of information system.

Objective To develop a data table system for monitoring the quality of pediatric intravenous infusion process and to evaluate its clinical effectiveness. Methods The data table system was designed to monitor the whole process of intravenous infusion by automatically capturing data from administration,inspection to completion,followed by the generation of personal digital assistant（PDA） scan identification data table and infusion inspection data table. The data table system was put into use since December,2020 in a tertiary children’s hospital in Shanghai. Data collected from October to November,2020 were compared with that from March to April,2021 in terms of PDA scanning rates at the beginning and end of intravenous administration,qualified rate of the number of intravenous infusion inspection,and accuracy rate of intravenous infusion inspection timing. The Effectiveness Evaluation Scale of Clinical Nursing Information System was used to evaluate nursing managers’ satisfaction. Results The PDA scanning rate at the beginning of intravenous administration was improved from 96.76% to 99.96%（P<0.001）;the PDA scanning rate at the end of intravenous administration was improved from 97.88% to 98.82%（P<0.001）;the qualified rate of the number of intravenous infusion inspection was improved from 57.96% to 66.85%（P<0.001）;the accuracy of intravenous infusion inspection time was improved from 95.68% to 96.79%（P<0.001）. The satisfaction score of nursing managers with the data table system was（95.25±0.08）. Conclusion The development of the data table system could help nursing management departments facilitate the use of the clinical data in order to continuously improve the nursing quality and nurses’ behavior. With the help of information service,the data table system for monitoring nursing quality provided a better user experience.

Objective To translate the Psychosocial Risk Assessment in Pediatrics （PRAP） into the Chinese version,and to test its reliability and validity. Methods The Chinese version of PRAP was formed after translation and cultural adjustment authorized by the original author. 167 children from Children’s Hospital in Shanghai from March to May 2021 were selected by convenience sampling method to evaluate the reliability and validity of the scale. Results The Chinese version of PRAP included 8 items,namely temperament,anxiety and coping during healthcare context,past health experience,developmental impact,special needs,communication,invasive procedure/experience and parent/caregiver stress. The Cronbach’s α was 0.711 and the half reliability was 0.626;the inter rater reliability of 5 investigators showed that the Kendall coefficient was 0.963 and the chi square value was 43.325;the difference was statistically significant（P<0.001）. The content validity index of each item is 0.90~1.00. The average content validity index of the scale is 0.95. There were 3 common factors being extracted by exploratory factor analysis,and the cumulative variance contribution rate is 62.686%. Conclusion The Chinese version of PRAP has good reliability and validity,and it can be used as an evaluation tool to evaluate the psychosocial risks of pediatric patients regarding to medical procedure in China.

Objective To construct the nursing monitoring data collection model of pediatric intensive care units and carry out clinical application,so as to improve the recording quality of medical and nursing data of critically ill children in ICU and the working efficiency of medical staff. Methods On the basis of the clinical information system（CIS）,a modern,informationalized and integrated mobile nursing system was established for the process construction of rescue mode,resuscitation mode,blood transfusion mode and special mode. Data collection patterns and nurses’ satisfaction were investigated from January 1,2019 to January 1,2020 in the ICU in different clinical scenarios. Results The rescue mode was started for 328 times;blood transfusion mode was started for 8 014 times;recovery mode was started for 1 622 times. A total of 4 323 cases were recorded by electronic medical records,including 1 793 cases of PICU,1 600 cases of NICU and 930 cases of CICU. The overall satisfaction score of nurses to the nursing monitoring data acquisition mode system was 92.47±1.62 scores. Conclusion The construction of different data collection modes of the PICU effectively integrates the document writing workflow for handling first aid,resuscitation and blood transfusion. The manual and informatic double-checking process ensures the scientific and effective bedside data collection in the ICU. The work procedures of nurses were simplified;the quality of nursing documents was improved;the nurse’s satisfaction with the working environment was improved.

This article summarized nursing experience of procedural feeding for five pediatric patients with complicated congenital heart disease underwent post-operative delayed chest closure. Key nursing points included: a procedural feeding program was developed together with pediatric cardiologists,cardiac surgeons,cardiac specialist nurse,nutritionists,gastroenterologists and rehabilitation specialists; minimal feeding was performed to maintain intestinal function; enteral nutrition was initiated as early as possible after full assessment of intestinal function,and initial feeding volume was set at 1 to 2 ml/（kg·h）; feeding intolerance was assessed by abdominal circumference measurement（once/12 h）,bowel sounds and gastrointestinal symptoms; implementation of enteral nutrition was advanced in an orderly and regular manner,and nutritional status of pediatric patients was continuously monitored,weight was assessed twice a week,and length of body was assessed once a week. All pediatric patients in this group successfully received chest closure,and all reached the full amount of oral feeding,who were discharged after the disease was relieved.