Objective To construct a pelvic floor muscle training program for patients undergoing radical prostatectomy，and to provide a reference for clinical practice. Methods The evidence related to pelvic floor muscle training in patients undergoing radical prostatectomy was systematically searched and the quality was evaluated. The draft of pelvic floor muscle training program for patients undergoing radical prostatectomy was constructed based on the KAP theory and it was demonstrated and revised by expert meetings. From February to March 2023，Delphi method was used to determine the final scheme. 37 patients were selected as the control group and 38 patients as the experimental group to implement the scheme and evaluate the application effect. Results 2 rounds of Delphi consultations were conducted among 17 experts，and the recovery rate of the questionnaire was 100%. The expert authority coefficient was 0.89. The Kendall harmony coefficients of the importance and feasibility of the second round of consultation were 0.270 and 0.209（P<0.001）. The coefficient of variation of importance and feasibility of items were 0~0.18 and 0~0.20. The final program included 3 first-level items，8 second-level items and 29 third-level items. 1 month after surgery，there was no significant difference in urinary incontinence score（P=0.242） and there was significant difference in pelvic floor muscle training compliance（P=0.011） between 2 groups. Conclusion The program was applied preliminary in clinical practice and it was confirmed with scientific and practical meaning，so it can provide a reference for clinical nursing.

Objective To investigate the level of self-advocacy ability of female breast cancer patients with chemotherapy，and to analyze its influencing factors，so as to provide references for clinical implementation of targeted intervention. Methods A total of 240 breast cancer patients with chemotherapy were investigated by general data questionnaire，Female Self-Advocacy in Cancer Survivorship Scale，Social Support Rating Scale，and Sense of Coherence Scale. Results The self-advocacy score of 240 breast cancer chemotherapy patients was（68.89±10.66）；there was a positive correlation between self-advocacy and social support（r=0.723，P<0.001）；it was also positively correlated with the sense of coherence（r=0.569，P<0.001）. The results of multiple linear regression analysis showed that age，educational level，social support and the sense of coherence were the influential factors of self-advocacy ability of breast cancer patients with chemotherapy，which explained 61.4% of the total variation. Conclusion The self-advocacy ability of breast cancer patients with chemotherapy is at medium level，and there are some problems in self-decision-making，effective communication with medical staff and seeking social support. Medical staff should pay attention to patients with advanced age and low education level，and help patients improve their sense of coherence and their ability to obtain and use social support，so as to improve the level of self-advocacy of patients.

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 summarize the perioperative nursing care of a patient with laryngeal cleft complicated with laryngomalacia after endoscopic laryngeal cleft repaired. The key aspects concerning nursing included the impose of importance on nutrition management to improve preoperative nutritional status，the implementation of aspiration risk assessment and prevention strategies to reduce the risk of aspiration pneumonia before surgery， the strengthening of postoperative care to prevent anastomotic rupture，the strengthening of airway management to improve postoperative pulmonary complications，the development of a care plan to improve discharge readiness. Following appropriate and successful perioperative treatment and nursing care，the patient was recovered and discharged from hospital 28 days after operation，and showed good recovery after 1 year of following up.

Objective To evaluate and summarize the best evidence on preventing venous thromboembolism in adult burn patients，and provide references for clinical practice. Methods We retrieved all evidence on the prevention of venous thromboembolism in adult burn patients from databases and websites，including UpToDate，Guidelines International Network（GIN），National Institute for Health and Care Excellence（NICE），Scottish Intercollegiate Guide Network（SIGN），National Guideline Clearinghouse（NGC），Yimaitong，World Health Organization （WHO），International Society for Burn Injuries（ISBI），Registered Nurses Association of Ontario（RNAO），Association of periOperative Registered Nurses（AORN），Joanna Briggs Institute（JBI），Cochrane Library，Web of Science，EBSCO，Embase，CINAHL，Clinicalkey，PubMed，CNKI， CBM，and Wanfang. The retrieval period was from the inception of databases to July 31，2022. There were 2 researchers with evidence-based nursing backgrounds who assessed the quality of the literature and extracted the data independently. Results A total of 15 articles were incorporated，including 2 clinical decisions，6 guidelines，1 systematic review，1 evidence summary，2 expert consensus，and 3 original studies. A total of 28 pieces of best evidence were summarized from 4 aspects，including risk assessment，preventive measures，documentary records，and health education. Conclusion This study summarized the best evidence for thromboprophylaxis in adult burn patients. Clinical staff could comprehensively combine the clinical situation and patients’ wishes to form a prevention program for venous thromboembolism in adult burn patients based on the best evidence. It will promote the evidence-based nursing practice of standardized thromboprophylaxis in burn patients.

Objective To systematically review the qualitative research on the disease experience of patients with prostate cancer,and to provide references for improving the mental health of this population and establishing a support system. Methods The databases of PubMed,Web of Science,Cochrane,Embase,Cochrane Library,CNKI,VIP,Wanfang,CBM were retrieved on qualitative research about the disease experience of prostate cancer patients. The retrieval period is from the establishment of the database to April 2021. The quality of the literature was evaluated by JBI Critical Appraisal Tool for qualitative studies. Results A total of 13 studies were included,and 50 clear study results were extracted. Similar study results were summarized into 8 new categories,and 3 integrated results were synthesized：self-perception changes in symptomatic prostate cancer patients accompanied by regression,leading to impaired male self-esteem and alienation in the intimate relationship of couples;differences in coping strategies among patients with different emotional experiences,which are manifested as avoidance of surrender and post-traumatic growth;patients have unmet needs in multiple dimensions,such as poor doctor-patient communication,lack of peer support,and low social attention,and they strive to seek relevant support. Conclusion Prostate cancer patients have many aspects of disease experience in the whole disease process. Healthcare professionals tend to ignore patients’ feelings and experiences,and should pay attention to and evaluate patients’ psychological feelings from multiple perspectives in the future. They should also provide comprehensive physical and mental care from the perspective of positive psychology to improve social support and improve their quality of life.

To summarize perioperative nursing care in a case with acute left heart failure caused by giant ball thrombus blocking micro orifice in left atrium. The nursing points are as follows：quickly improving pre-operative preparations,activating the emergency team of the cardiac special bank,and preparing equipment and items;during the operation,rapidly establishing extracorporeal circulation,strengthening the blood management,carrying out the phased temperature management,conducting active blood sugar management and clustered surgical infection management;management and psychological care of post-complication. The patient was well rehabilitated and discharged from the hospital 27 days after surgery.

Objective This study aims to construct a grief counseling programme for women undergoing termination of pregnancy due to fetal anomaly（TOPFA） and apply the programme to clinical practice，so as to provide references for future work. Methods Through qualitative research and literature research，a grief counseling programme was drafted and constructed. From March to April 2021，19 experts were consulted using Delphi method，and a grief counseling programme for pregnant women with fetal anomaly was formed. From June 2021 to November 2021，the convenience sampling was used to select pregnant women with fetal malformation in an obstetrics and gynecology hospital in Hangzhou as the research subjects. The experimental group was given the grief counseling programme on the basis of routine care，while the control group was given routine care. Perinatal Grief Scale（PGS） was used to evaluate the application effect of the programme. Results The effective recovery rates of the questionnaire were 90.48% and 100%，the expert authority coefficients were 0.845 and 0.861，and Kendall harmony coefficients were 0.323 and 0.262（P<0.001）. Finally，the established grief counseling programme for women with fetal anomaly included 6 first-level items and 34 second-level items. The increase of PGS score in the experimental group was 1.50（-7.75，16.50） which is lower than that in the control group of 16.00（11.00，29.50），Z=-2.123（P<0.05）. Conclusion The grief counseling programme constructed in this study is scientific and practical，and the programme could reduce their grief level a month after the delivery. The programme can be popularized and applied after further verification.

We summarized the nursing experience of the hospital-community-family nursing model in the treatment of elderly patients with stress injury at home. The key points of nursing care were clarifying the responsibilities of the hospital and community,establishing hospital-community linkage nursing cooperation teams,and strengthening organization and management;strengthening the training of community medical staff in wound management skills to improve wound management capabilities;formulating home assessment scale for elderly patients with pressure injury to improve the wound assessment ability of community medical staff;timely consultations to guide community medical staff in wound management;establishing hospital-community two-way referrals and implementing hierarchical treatment;strengthening multidisciplinary collaboration and promoting wound healing;carrying out continuous home care,and improving the compliance of patients and caregivers with treatment and nursing. Among 30 patients with elderly pressure injury at home in this group,26 of them achieved wound healing and 4 improved,with a cure rate of 86.67%.

Objective By optimizing the in-hospital process of extracorporeal cardiopulmonary resuscitation,the rescue time is shortened and the occurrence of adverse events is reduced. Methods In October 2018,our hospital established a medical failure mode and effect analysis management team. The healthcare failure mode and effect analysis model was applied to analyze the shortcomings of extracorporeal cardiopulmonary resuscitation emergency process,and the emergency process was optimized through literature reviews,expert discussions and consultations,so as to construct standardized extracorporeal cardiopulmonary resuscitation in-hospital emergency process and apply it to the clinic in January 2019. After 2 years of clinical application,we analyzed and compared the risk priority index before and after the optimization process,the time spent in each link and the occurrence of adverse events. Results After the optimization of the emergency process,the risk priority index dropped from（217.63±20.60） points to（102.73±39.95） points;the time spent in each link was shortened;the incidence of various adverse events decreased,and the differences were statistically significant（P<0.05）. Conclusion The application of healthcare failure mode and effect analysis to optimize the in-hospital emergency process of extracorporeal cardiopulmonary resuscitation can effectively improve the delay of first aid and reduce the occurrence of adverse events.

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 To construct an individualized management scheme of fluid intake for patients with chronic heart failure（CHF） and discuss its application effect. Methods Based on the previous results of “maximum cumulative fluid balance and number of days for CHF patients with safe volume load” and overhydration（OH） value at the time of entry,an individualized management scheme of fluid intake for patients with CHF was developed. Using the convenience sampling method,278 patients with CHF admitted to a tertiary first-class hospital in Jiangsu Province from May to October 2020 were selected. By the random number table method,the patients were randomly divided into an experimental group （139 cases） and a control group （139 cases）. The experimental group adopts an individualized management scheme of fluid intake,and the control group adopts the department’s routine fluid management strategies and we evaluated the effect of the intervention. Results After the intervention,OH value,estimated plasma volume status,Clinical Congestion Scale,Thirst Distress Scale-Heart Failure,the Minnesota Living with Heart Failure Questionnaire,3-and 6-month post-discharge readmission rates in the experimental group were lower than those in the control group（P<0.05）. There was no significant difference between 2 groups in 3- and 6-month post-discharge cardiac mortality （P>0.05）. Conclusion The individualized management scheme of fluid intake for patients with CHF can improve volume status and quality of life,providing a basis for management of fluid intake for patients with CHF.

Objective To evaluate the application and effects of a modified version of early cardiac rehabilitation program in patients with acute ST-segment elevation myocardial infarction treated by Percutaneous Coronary Intervention（PCI）.Methods Totally 112 patients with acute ST-segment elevation myocardial infarction undergoing PCI enrolled in Coronary Care Unit（CCU） were randomized into a control group and an experimental group with 56 cases in each group. The experimental group was given a modified version of the early cardiac rehabilitation program,while the control group received routine exercise training. The Activity of Daily Living Scale（ADL）,left ventricular ejection fraction（LVEF）,the length of hospital stay and the incidence of adverse events were compared in both groups before the intervention and at 7th day after the intervention,and the satisfaction of patients was investigated through interviews.Results After a week of interventions,results of ADL and LVEF in the experimental group was significantly higher than those in the control group. The length of hospital stay in the experimental group was shorter than that in the control group. The differences of 3 statistical results were statistically significant（P<0.01）. No adverse events occurred in both groups. Participants in the experimental group claimed that the modified rehabilitation program could be used to help them recover their self-care ability and rebuild their confidence to return to life according to patients own conditions as soon as possible,and all of them could cooperate actively.Conclusion The modified version of the early cardiac rehabilitation program is safe and effective that can be used to accelerate the rehabilitation of patients with acute myocardial infarction after PCI,increase LVEF,improve the daily self-care ability of patients,shorten the length of hospitalization,and improve the quality of life of patients.

Objective To summarize the management measures for caregivers of inpatients in a tertiary hospital in China during the coronavirus disease 2019（COVID-19） epidemic. Methods The comprehensive management was carried out in caregivers of inpatients from the aspects of quantity control,risk screening,epidemic investigation and notification,double card management of “ID card and companion card”,auxiliary inspection and accompany inspection service,pre-examination and verification of medical insurance,etc. The time point inspection was implemented to evaluate the effects,and the results were fed back by information means to promote the continuous improvement of quality. Results From January 28,2020 to March 2,2020,the ratio of patients and caregivers was 1 ∶ 1.083 and 1 ∶ 1.002 at a week before and after the implementation of the comprehensive management,and the ratios were 1 ∶ 0.988,0.932 and 0.918 at the second to fourth weeks after the implementation. The results of 3 time points inspections showed that the management quality of many items,including the implementation of the access control management,the accompanying staff signing the notice,the routine temperature monitoring twice a day,and no dining out,had been improved continuously（P<0.05）. The implementation rate of the double card management at entrances of elevators was 23%~46%. The accuracy rate of masks wearing at entrances of hospital and elevators was high（91%~100%）,but the accuracy rates of masks wearing in inpatient wards were low with 58.76%,61.54% and 77.69%,respectively at 3 time points inspections. Conclusion It is effective to implement the whole process management measures for the caregivers of inpatients from pre-hospital,in-hospital to post-hospital. The implementation rate of double card management at elevator entrances,the accuracy rate of mask wearing in inpatient wards were relatively lower,which need further improvement.

Objective To summarize the experience of prevention and control management in a hemodialysis centers during the coronavirus disease 2019（COVID-19） epidemic,and to improve the effects in order to reduce the occurrence of COVID-19 infection. Methods Through developing the standards for prevention and control of COVID-19 in hemodialysis centers,267 hemodialysis centers in Zhejiang province were trained in the aspects of organization management,prevention and control procedures,patient education and management,staff training and management. We also standardize the diagnosis procedures of hemodialysis during the COVID-19 epidemic,and standardize the isolated hemodialysis procedures of confirmed cases,suspected cases and patients observed at home. Results There were 2 confirmed COVID-19 cases out of 32071 hemodialysis patients in Zhejiang Province,and 10 hemodialysis patients in close contact with them were also taking isolation dialysis. No COVID-19 infection occurred after medical observation of 14 days. There were also no infections after 14 days’ medical observation among 8 suspected cases and 78 home observation patients who were treated with standard isolation dialysis or continuous renal replacement therapy. None of the 4 700 medical staff suffered from the nosocomial infections of COVID-19. Conclusion The practice in hemodialysis centers is effective in preventing and controlling the COVID-19 infection in the provincial hemodialysis centers, which can reduce or even block the infection in hemodialysis patients

Objective To develop a standardized training program for the prevention and control of coronavirus disease（COVID-19）infections in general hospitals and evaluate its effectiveness. Methods The training targets included medical staff and auxiliary staff. A working team with clear responsibilities was set up,and personalized training content was formulated. Online and offline training were adopted,and the effectiveness was tracked and evaluated by multiple methods. Results 7 days after the implementation of the standardized training program,the score of knowledge related to the prevention and control of nosocomial infection rose from 69.02±13.21 to 88.49±10.57 after the training for medical staff. The score of auxiliary staff was also improved from 62.38±13.05 to 75.86±12.19 with statistical significances（ P< 0.05）. The correct rate of questions and answers by supervisors on the spot rose from 82.69% to 92.31%,whilethe standard rate of wearing surgical masks increased from 85.36% to 92.86%,and the correct rate of hand hygiene increased from 92.31% to 96.30%. Conclusion The standardized training program for nosocomial infection prevention and control of COVID-19 in general hospitals has effectively improved the knowledge of nosocomial infection prevention and control,the standard rate of wearing masks,and the correct rate of hand hygiene for medical staff and medical assistants

Objective To search and summarize the best available evidence on management of output and input in chronic heart failure patients. Methods We searched the BMJ Best Practice,UpToDate,Joanna Briggs Institute,Guideline International Network（GIN）,National Guideline Clearinghouse（NGC）,National Institute for Health and Care Excellence（NICE）,Registered Nurses Association of Ontario（RNAO）,Scottish Intercollegiate Guidelines Network（SIGN）,Chinese Guideline Network,Cochrane Library,PubMed,Embase,CINAHL,CBM,World Health Organization（WHO） and various professional association websites,etc.,to collect evidence including guideline,best practice information sheet,evidence summary,recommended practice,and systematic review on management of output and input in chronic heart failure patients. 2 authors independently assessed quality and extracted data. Results Totally 8 articles were enrolled,including 1 clinical decision,5 guidelines,2 systematic reviews,and 1 expert consensus. Finally 13 pieces of best evidence were summarized including the multidisciplinary cooperation team,assessment and monitoring,sodium and fluid restriction,usage and regulation of diuretic,aerobic exercise and patient education. Conclusion Our research summed the best evidence on management of output and input in chronic heart failure patients. Nursing managers should establish a scientific management system for output and input,provide regular training for members,and develop programs of individualized body fluid management for patients.

Objective To construct the evaluation system for standardized training effects of new nurses based on Koch’s four-level evaluation model.Methods Through literature review,expert interviews,the index items and evaluation time points and methods of each dimension of the evaluation system were preliminarily established. Two rounds of consultation were conducted among 18 experts in nursing management,clinical nursing teaching management and college nursing education by Delphi method.Results In this study,the evaluation system included four first-level indicators：response level,learning level,behavior level and result level. There were 16 second-level indicators and 48 third-level indicators.Conclusion The degree of coordination and consensus of experts was high. The evaluation system of standardized training effect for new nurses is scientific and reliable. It can provide scientific basis for hospital nursing managers to evaluate the training effect of new nurses and improve the training program.

Objective To investigate the current situation of medical equipment management in operating rooms in Chinese hospitals,and to provide basis for improving and perfecting the management methods of medical equipment in operating rooms. Methods Using stratified sampling method,chief head nurses,head nurses,key nurses,directors of nursing department,and professionals in equipment management in 513 hospitals in China were selected to complete a questionnaire survey. The self-designed questionnaire included general information and the status quo of equipment management in operating room. Results In the investigated 513 hospitals,269（52.44%） of the hospitals had no benefit evaluation of equipments,220（42.88%） of the hospitals had no management system for idle equipment,162（31.58%） of the operating room nurses did not participate in the pre-use training of new equipment,400（77.97%） of the hospitals still had manufacturer guidance;205（39.96%） of the hospitals’ equipments exceeded the service life according to the instructions,161（31.38%） of the hospitals did not record the usage process,192（37.43%） of the hospitals have no full-time staff for daily regular maintenance,only 50（9.75%） of the hospitals realized equipment information management,273（53.22%） of the hospitals had no retrospective management of equipments. Hospital level had influence on six dimensions,which were purchase management,benefit evaluation management,use process management,information management,maintenance management and retrospective management of medical equipment in operating room（P<0.05）. Operating room size had an impact on four dimensions,which were purchase management,benefit evaluation management,information management and maintenance management of medical equipment in operating room（P<0.05）. Conclusion Each hospital is not perfect in purchase management,benefit evaluation management,information management and retrospective management of medical equipment in operating room,and is lacking professional training and effective preventive maintenance of equipment usage. Each hospital needs to carry out management of medical equipment in operating room in different levels and in a planned way in accordance with different medical needs,so as to ensure smooth surgery process and patient safety.

Objective To understand the real experience and influencing factors of newly employed nurses on intention for selecting department who received standardized training. Methods Using semi-structured interviews,11 new nurses from 3 tertiary hospitals in Beijing were interviewed. Interviews were analyzed using thematic analysis. Results The good organizational atmosphere during rotation,especially the interpersonal relationship,positive support,and head nurses’ humanistic management philosophy were the most important factors for department selection. The importance of the salary in the department and work intensity was weaker than the organizational atmosphere. Nurses rarely considered about their professional development and work goals. Conclusion Clinical nursing management departments should pay more attention to interpersonal relationship,positive support,and head nurses’ humanistic management philosophy in the organizational atmosphere. At the same time,performance appraisal of the department should be balanced,nurses should be guided to consider future career development.

Objective To investigate the psychological distress ， self-disclosure and intimacy among spouses of gynecological cancer patients ， and to explore the path relationship among three aspects. Methods A total of 191 spouses of gynecological cancer patients from 8 tertiary hospitals were investigated with Distress Disclosure Index ， Distress Thermometer and Short Marital Adjustment and Prediction Test from September 2014 to March 2015. Results The
prevalence of psychological distress among spouses of gynecological cancer patients was 64.4%. There was a significant difference in DT score among the spouses of patients with different education level （ P<0.05 ） . The scores of Distress Disclosure Index ， Distress Thermometer and Short Marital Adjustment and Prediction Test were negatively correlated. Furthermore ， intimacy took partial effects as a mediator in self-disclosure as to affect psychological distress.
Conclusion The prevalence rate of psychological distress among spouses of gynecological cancer patients is high.Low level of self-disclosure and low degree of intimacy with their wives may be the related factors of psychological distress of spouses.