Objective To construct an “Internet+ TCM nursing service” talent cultivation model in Zhejiang Province and to evaluate its application effect. Methods Based on the literature review and expert panels，the “Internet+ TCM nursing service” talent cultivation model was constructed in Zhejiang Province. A total of 63 trainees from 63 TCM and integrated traditional Chinese and Western medicine hospitals in the province were selected to carry out for 45 days of theoretical training and 9 days of clinical skills training. After the training，the training effect was evaluated by theoretical knowledge，TCM nursing skills，scenario simulation case assessment，trainees’ satisfaction，as well as a survey on the results of practice. Results The constructed talent cultivation model contains course contents including theoretical learning，skill training and emergency home treatment management and corresponding assessment programs. Sixty-three trainees successfully completed the course with the theoretical score of （92.24±3.64），the skill score of （97.13±2.53），and the situational case score of （95.78±3.02）. Fifty-five trainees（87.30%） were assessed as “excellent” and 8（12.70%） as “good”. The trainees’ satisfaction about the overall module design of the project was（4.93±0.23） and 415 cases of “Internet+ TCM nursing service”were carried out. Conclusion The “Internet+ TCM nursing service” talent cultivation model in Zhejiang Province has strong applicability and remarkable training effect，which can provide references for the implementation of “Internet+ TCM nursing service” in other regions.

Objective To develop the Quality of Life Scale for Patients with Aplastic Anemia（QLS-AA） and to test its reliability and validity. Methods According to the concept category and the four-dimensional model of quality of life，the scale item pool was initially constructed through literature review and qualitative interview. The draft of the QLS-AA was formed through expert inquiry，cognitive interviews and expert consultation. A questionnaire survey was conducted on 429 patients with aplastic anemia from the hematology departments of a tertiary general hospital in Zhejiang Province and a tertiary hematology hospital in Tianjin with the convenient sampling method from December 2021 to November 2022，and the item analysis and reliability，validity test of the pre-test scale were carried out. Results 422 valid questionnaires were collected，and the effective questionnaire recovery rate was 98.37%. 3 common factors were extracted by exploratory factor analysis，and the cumulative variance contribution rate was 66.113%. The scale level consensus content validity index was 0.821，the scale level average content validity index was 0.970，the item level content validity index was 0.833~1.000，and the correlation coefficient with SF-36 was 0.719. The Cronbach’s α was 0.944，and the split half reliability was 0.882，and retest reliability was 0.931. The final QLS-AA includes 3 dimensions with 39 items. Conclusion The process of developing QLS-AA in this study is scientifically standardized，and the scale has good reliability and validity，which can effectively evaluate the quality of life for patients with aplastic anemia.

Objective To construct a standardized management scheme for traditional Chinese medicine nursing technology in Zhejiang Province，to further unify the names and classifications of traditional Chinese medicine nursing technology，to formulate technical classification principles and personnel qualification access conditions，and to promote the homogeneous management and quality improvement of traditional Chinese medicine nursing technology. Methods From August 2020 to March 2022，a research group was set up，and the first draft of the standardized management scheme of traditional Chinese medicine nursing technology in Zhejiang Province was formed with the combination with literature research and investigation results. The scheme was formulated by Delphi expert consultation and expert discussions，and it was validated by technology graded predictive models. Results A total of 35 experts were consulted by the Delphi method，and the effective recovery rate of the questionnaire was 100%；the expert familiarity coefficient Cs was 0.917；the judgment coefficient Ca was 0.909，and the expert authority coefficient Cr was 0.913. There are 80 items in 11 categories，and a technical grading principle has been formulated including 3 dimensions，namely safety，difficulty in learning and mastering，and difficulty in operating methods. 2 prediction models were constructed according to the technical grading influencing variables and the ROC curve was drawn，and the area under the ROC curve was obtained as 0.904. In the end，a total of 56 items of 8 categories of Chinese medicine nursing technology in Zhejiang Province were determined through the expert discussion meeting，and the qualification access conditions of Chinese medicine nursing technology personnel were formulated according to the grading principle. Conclusion The standardized management scheme of traditional Chinese medicine nursing technology has a high scientific nature，which provides a guarantee for the quality of clinical practice of traditional Chinese medicine nursing，and at the same time helps to promote the development of traditional Chinese medicine nursing.

Objective To understand the status of Traditional Chinese Medicine（TCM） nursing service in general hospitals in Zhejiang province，and to provide reliable data for relevant departments to formulate supporting policies，so as to promote the sustainable development of TCM nursing service in Zhejiang province. Methods From August to November 2022，a whole-group sampling method was used to survey 103 general hospitals in Zhejiang Province using a self-designed questionnaire on the current status of TCM nursing services in general hospitals in the province. The questionnaire included 3 aspects：basic information of the hospital，current status of TCM nursing services and supportive needs for the development of TCM nursing services. Results A total of 103 valid questionnaires were collected，and the effective questionnaire recovery rate was 100%. Among the 103 hospitals，54（52.43%） are tertiary hospitals and 42（40.78%） are secondary hospitals，and 7（6.80%） are other hospitals. 91（88.35%） hospitals carried out TCM nursing services；73（80.22%） hospitals carried out no less than 5 TCM nursing technical items；34（37.36%） hospitals carried out no less than 4 TCM nursing technical categories；29（31.87%） hospitals served no less than 10，000 cases of patients per year with TCM care technology，and 24（26.37%） hospitals opened TCM nursing care clinics. The demand for support in the development of TCM nursing services is mainly related to the demand for policies，hospitals and training. Conclusion TCM nursing services in general hospitals in Zhejiang Province are well developed. However，there are still problems such as the insufficient development of TCM nursing clinics，unbalanced previous development of different levels of hospitals，shortage of TCM nursing talents，and imperfect quality supervision system，etc. In the future，TCM nursing support，talent training and standardized management should be further strengthened to promote the sustainable and steady development of TCM nursing in general hospitals.

Objective To construct the excellent talent cultivation model of TCM nursing and to evaluate its cultivation effect. Methods Based on the literature review and expert panels，the excellent talent training model of TCM nursing in Zhejiang Province was constructed. A total of 60 trainees in the province were selected to carry out a three-year training of excellent talents in TCM nursing in 2018. The final grades and a self-designed training effectiveness questionnaire were employed for evaluation，and a survey on the trainees’ satisfaction was conducted. Results The training model includes theoretical studies，clinical practice and skills training，as well as the development of teaching and research skills，and a corresponding assessment scheme. 54 trainees successfully completed the course with an overall completion score of （260.51±13.58）. The trainees’ nursing ability and scientific research level of TCM nursing have been greatly improved，and their overall satisfaction score for the training was （4.83±0.42）. Conclusion The TCM nursing excellent talent cultivation model in Zhejiang Province has achieved good results，which can provide references for the training of TCM nursing talents in other areas.

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 To explore the current situation of Traditional Chinese Medicine（TCM） nurse-led clinics in Zhejiang Province, and to provide a basis for the management and formulation of related policies. Methods From July 2020 to November 2020,our hospital used the questionnaire of TCM nurse-led clinic survey to investigate the infrastructure,operation mode and personnel qualification of the public TCM institutions in Zhejiang Province. Results 94 hospitals participated,and we got 94 valid questionnaires. The survey shows that 74.47% of hospitals have independent TCM nurse-led clinics,and 80.00% of them were opened in recent 5 years,and only 32.86% have full-time staff. 57.14% of TCM nurse-led clinics carry out over 10 suitable TCM technologies; the average daily outpatient volume was up to 200,with a wide range of diseases,including pain,sleepless,disease treatment,etc.;34.29% of TCM nurse-led clinics carry out Internet+ nursing services. Conclusion TCM nurse-led clinics in Zhejiang public TCM institutions are developing fast. It meets the health needs of patients,and promotes innovative development of TCM nursing. In the future,we should further strengthen the connotation of TCM nursing,promote relevant policies,systems and service standards,pay attention to infrastructure construction and vigorously develop TCM Internet+ nursing services.

Objective To evaluate and summarize the relevant evidence of falling prevention in patients with Parkinson’s disease,in order to provide references for clinical medical staff. Methods The evidence-based nursing method was used to systematically retrieve the clinical decisions,guidelines,evidence summaries,systematic evaluations and expert consensuses on the prevention of falls in patients with Parkinson’s disease in relevant databases at home and abroad and professional academic websites of Parkinson’s disease. The retrieval time limit was from the establishment of the databases to August 31,2021. After the methodological quality evaluation,the evidence was extracted and summarized according to the subject. Results A total of 18 pieces of the literature were involved,including 2 clinical decisions,2 guidelines,1 evidence summary,12 systematic reviews and 1 expert consensus. Combined with the judgment of professionals,the evidence was summarized from 5 aspects：evaluation and monitoring,daily safety management,sports management,nutritional support and education and training,and 24 pieces of best evidence were formed. Conclusion This study comprehensively and scientifically summarizes the best evidence of fall prevention and management plan for patients with Parkinson’s disease. In the process of evidence transformation,evidence users should consider specific situations,pertinently select the evidence,formulate the individualized fall prevention and management plan for patients with Parkinson’s disease,reduce the risk of falls and improve the quality of care.

Objective To construct and verify a risk nomogram prediction model of lower extremity deep venous thrombosis（DVT） in patients with acute stroke. Methods A prospective study design was adopted. 602 patients with acute stroke hospitalized in a tertiary general hospital in Nanning，Guangxi province from January 2020 to April 2021 were selected as the research subjects，of which 415 patients from January 2020 to December 2020 were allocated into the modeling group and 187 patients from January 2021 to April 2021 in the validation group for external validation. Univariate and multivariate logistic regression were used to analyze the risk factors of lower limb DVT in acute stroke，to establish the risk prediction model and draw the nomogram model. Receiver operating characteristic（ROC） and Hosmer lemeshow were used to verify the predictive effect of the model. Results 35 of 415 cases in the modeling group had DVT，with an incidence of 8.4%;19 of 187 cases in the validation group had DVT，with an incidence of 10.2%. The results of univariate analysis in the modeling group showed that age，diagnosis，bed time，state of consciousness，degree of hemiplegia，smoking history，atrial fibrillation history，thrombosis history，use of dehydration drugs，and central venous catheterization，fibrinogen and D-dimer quantification were the influencing factors of DVT in patients with acute stroke. Multivariate logistic regression analysis showed that age，state of consciousness，degree of hemiplegia，the use of dehydrating drugs were independent risk factors for DVT of acute stroke（OR values were 1.901，1.702，1.940 and 3.231，all P<0.05）. The nomogram model was constructed with the above 4 factors;the area under the ROC curve of nomogram model is 0.850;the maximum value of Jordan index is 0.758;the sensitivity is 83%;the specificity is 82%;the best critical value is 0.071. Hosmer-Lemeshow test χ²=2.143，P=0.951;when the area under the ROC curve of the external verification group is 0.893 and the maximum value of Jordan index is 0.746，the sensitivity is 90%，the specificity is 85%，and the best critical value is 0.084. Conclusion The nomogram model can predict the risk DVT of acute stroke，and help to formulate personalized intervention measures.

Objective To test the reliability and validity of Post Competency Assessment Scale for nurses in central sterile service departments（CSSD）. Methods According to the Iceberg Competency Model,an evaluation index framework for the competency of nurses including 4 first-level indexes and 58 second-level indexes was formed through Delphi consultation in previous research. The members of the research group further transformed the indexes to a 60-item post competency assessment scale for nurses in CSSD. 6 experts assessed the content validity of the scale;from May to June 2021,34 nurses in CSSD from 3 hospitals in Beijing were selected for preliminary survey;from September to October 2021,630 nurses from 2 provinces were selected for formal investigation,so as to test the reliability and validity of scale. Results The scale contained 4 factors,including theoretical knowledge,operational skills,comprehensive ability and personal characteristics,with a total of 60 items. The content validity of the total scale was 0.970,and the scale-level content validity index/average were 0.830~1.000;4 factors were identified by exploratory factor analysis,accounting for 71.51% of the total variance. The overall Cronbach’s α coefficient was 0.989. The overall split‐half reliability was 0.951. The test-retest reliability was 0.840. Conclusion The Post Competency Assessment Scale for nurses in CSSD has good reliability and validity. It can be used as a tool to assess the post competency for nurses in CSSD,and a reference for hospitals to make training plans and annual assessment.

Objective To develop the post competency index system for nurses in Central Sterile Service Department,so as to provide scientific bases for the homogenized,standardized training strategy and evaluation of the competence level of the nurses in Central Sterile Service Department. Methods According to the Iceberg Competency Model,the paper drew up an evaluation index framework for the competency of nurses and prepared the inquiry paper of expert letters based on methods as document analysis. 3 rounds of Delphi consultation questionnaires were sent to 20 experts from 11 provinces and cities in May 2020. They were experienced in areas of management of central sterile supply,and helped to define the post competency index system for nurses in Central Sterile Service and its weight assignment. Results The established post competency index system for nurses in Central Sterile Service consisted of 4 first-level indexes,including theoretical knowledge,operational skills,comprehensive ability and personal characteristics,58 second-level indexes after 3 rounds of Delphi consultations. The effective response rate was 100%. The three-round authority coefficient values were 0.88,0.88,and 0.89 respectively. The Kendall harmony coefficients of expert opinions of the 3 rounds of first and second-level indexes were 0.301,0.343,0.413 and 0.322,0.256,0.292,respectively,and P<0.001 after the consistency test. Conclusion The post competency model for nurses in Central Sterile Service Department constructed in the study is reliable,scientific and practical,which will pro-vide objective quantitative bases for post training and evaluation for nurses in Central Sterile Service Department.

Hematopoietic stem cell transplantation（HSCT） is an effective therapy for the treatment of malignant and non-malignant refractory hematopathy. Sarcopenia is one of the serious complications in HSCT patients,which affects the recovery and prognosis of the patients. This article reviews the screening and assessment of sarcopenia,analyses the risk factors of sarcopenia in HSCT patients and the current common non-pharmacological interventions,then makes recommendations for sarcopenia management,aiming to provide references for clinical medical staff to carry out early prevention,early detection and timely intervention for such patients.

Objective To investigate the current status of the classification of traditional Chinese medicine（TCM）nursing techniques in Zhejiang,and to provide references for the TCM nursing training,management and policy formulation. Methods A self-designed “TCM Nursing Techniques Classification Questionnaire” was used to conduct in TCM medical institutions in Zhejiang from August to September 2020. The contents of the survey include the methods of technique classification,the principles and the current status. Results A total of 94 hospitals were investigated,among which 92 valid questionnaires have been received. The results revealed that 72 medical institutes had implemented TCM nursing techniques classification with 6 methods,accounted for 78.26%. The main classifying methods were level 1,level 2 and level 3,which were implemented by 52.78% of institutions. However,as the classification principles among the hospitals were not unified,the techniques classification were not consistent,and there are differences in some of techniques classifications. Conclusion TCM medical institutions at all levels in Zhejiang attach great importance to the management of TCM nursing techniques classification,but lack of homogeneity. Therefore,it is recommended to formulate management strategies of techniques classification,to clarify the methods and principles of classification,to unify the classification of various techniques,and to improve the standardization of technique application.

The management experience of fever clinics for safe collecting of nasopharyngeal swabs of suspected coronavirus disease 2019（COVID-19） infection in our hospital were summarized. The key points include establishment of individual collection room,strict sterilization of entire environment,training of professional nurses,enhancement of personal protection,standardization of method and procedures in collection and timely and safe submission of samples. More than 11,000 nasopharyngeal swabs were successfully collected by only 8 nurses. There is an average of more than 1,375 collections performed by each nurse without any incidence of infection in the process.

Objective To retrieve,appraise and integrate the available evidence of exercise regimens for gestational diabetes mellitus patients,and to provide foundation for decision-making in clinical nursing practice. Methods We searched the BMJ Best Practice,UpToData,Guidelines International Network（GIN）,Registered Nurses’ Association of Ontario（RNAO）,American Diabetes Association（ADA）,Chinese Medlive Guidelines Network,Cochrane Library,PubMed,CNKI,Wanfang Date to collect all articles on exercise regimens for gestational diabetes mellitus,including guidelines,systematic reviews,evidence summaries,recommended practice and expert consensuses. The retrieval period was from the inception to May 2019. JBI evidence appraisal and recommendation system was used to evaluate quality of studies and level of evidence. Results Totally 16 articles were selected,and a total of 31 items of best evidence were summarized from 8 aspects,including applicable population of gestational diabetes exercise interventions,benefits,risks,assessments,types,intensity,time and precautions. Conclusion Moderate exercise is safe and effective for patients with gestational diabetes. Clinical nurses should guide patients to exercise moderately during pregnancy by applying the best evidence with scientific nursing intervention.

Objective To retrieve,appraise and integrate the available evidence on mechanical prophylaxis of venous thromboembolism（VTE） in patients with intracerebral hemorrhage so as to provide reference for clinical practice to decrease the rate of VTE.Methods Using the method of evidence-based nursing,clinical question regarding mechanical prophylaxis for venous thrombosis with cerebral hemorrhage was raised. Relevant studies were retrieved by computer search. JBI evidence appraisal and recommendation system were used to evaluate quality of studies and level of evidence.Results A total of 16 items of best evidence were summarized,including mechanical device selection,application methods,time arrangement,contraindication of mechanical prevention and disease observation.Conclusion It is safe and effective for patients with cerebral hemorrhage to adopt mechanical measures to prevent venous thromboembolism. Clinical nurses can apply the best evidence to guide practice and improve nursing quality.

Objective To explore the influence of cognitive intervention program on undergraduate intern nursing students’ professional identity and professional self-efficacy.Methods Two comprehensive tertiary class-A hospitals which were comparable in scale,salary,hospital environment and quality of teaching staff,were selected using convenience sampling method,and were randomly assigned as the experimental group and the control group. Convenience sampling method was used to recruit 75 nursing students in the experimental group and 69 nursing students in the control group. The intervention program was based on ABC Theory and Broaden-and-Build Theory. The experimental group was given a 5-times cognitive intervention training biweekly based on the routine training. The intervention program mainly consisted of the online and offline lectures and the interactive discussion in class. The control group was given a 5-times routine professional learning during intern practice.Results A total of 138 nursing students completed the study. The overall score of nursing students’ professional identity and professional self-efficacy in the experimental group was better than those in the control group and the differences were statistically significant after the intervention（P<0.05）.Conclusion The intervention program based on ABC Theory and Broaden-and-Build Theory can improve intern nursing students’ professional identity and professional self-efficacy effectively.