Objective To evaluate effectiveness of evidence-based nursing practice of postoperative delirium management during cardiac surgery under cardiopulmonary bypass. Methods The best evidence was selected for the prevention and management of delirium after cardiac surgery under cardiopulmonary bypass. From May 2022 to April 2023，the evidence-based nursing practice was developed and applied into the Department of Cardiovascular and Macro-vascular Surgery of a tertiary A general hospital in Wuhan. The nurses’ knowledge，belief and practice of postoperative delirium，incidence of postoperative delirium and subdelirium syndrome，the implementation rate of examination indicators were compared before and after the application of evidence. Results A total of 27 articles were finally included. Based on this，23 pieces of the best evidence were selected，and 27 review indicators were constructed. Through evidence-based practice，the scores of nurses’ knowledge，belief and practice questionnaire were significantly increased from（100.81±13.92） to （105.51±10.35）（P<0.05）. The implementation rate of 24 indicators was significantly higher compared with baseline review（P<0.05）. The incidence of delirium decreased from 43.5% to 34.7%（P=0.120）. The incidence of postoperative subdelirium syndrome decreased from 55.1% to 40.1%（P=0.010）. The duration of postoperative delirium and sub delirium significantly decreased，respectively（P<0.05）. Conclusion Evidence-based practice can reduce the incidence of subdelirium syndrome，and it can reduce postoperative delirium and the duration of subdelirium syndrome. It can improve nurses’ knowledge and practice of postoperative delirium care.

Objective To explore the mediating effects of perceived stress and uncertainty tolerance on health literacy and decision satisfaction of decision makers in patient undergoing cardiac macrovascular surgery，and to provide references for improving the satisfaction of decision-making. Methods 260 surgical patient’s decision-makers in the cardiac macrovascular surgery of a hospital in Wuhan were selected by convenience sampling. All Aspects of Health Literacy Scale，Perceived Stress Scale，Intolerance of Uncertainty Scale-12 and decision satisfaction scale were used to investigate. Results 251 valid questionnaires were recovered，with an effective recovery rate of 96.54%. The health literacy score was（23.05±5.61）；the perceived stress score was（20.31±6.08）；the uncertainty tolerance score was（26.41±5.94）；the decision satisfaction score was（43.86±10.54）. The 4 variables were correlated（P<0.001）. The mediating model found that health literacy had a significant direct effect on decision satisfaction. Meanwhile，health literacy also indirectly affected decision satisfaction through 3 paths，including the independent mediating effect of perceived stress（β=0.096，P<0.001），the independent mediating effect of uncertainty tolerance （β=0.093，P=0.001），the chain mediating effect of perceived stress and uncertainty tolerance（β=0.076，P<0.001），accounting for 49.17% of the total effect. Conclusion Perceived stress and uncertainty tolerance play a mediating role in the relationship between health literacy and decision satisfaction of decision makers in cardiac macro-vascular surgery，which can improve decision makers’ health literacy，reduce perceived stress，and help them perceive surgical risks rationally，thus improving decision satisfaction.

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.

Objective To retrieve，evaluate and summarize the best evidence of perioperative management for patients with aortic dissection. Methods According to the“6S” model，we used evidence-based nursing method to retrieve the relevant literature，including clinical decisions，guidelines，evidence summaries，expert consensuses，systematic reviews，etc. The retrieval time limit was from the database construction to January 24，2022. There were 2 researchers who evaluated the quality of the literature，and extracted recommendations and research conclusions from the included literature. Results Totally 24 articles were involved，including 8 clinical decisions，4 guidelines，8 expert consensuses，2 systematic reviews，1 cohort study and 1 case-control study. Finally，15 pieces of best evidence about risk factors assessment，illness monitoring，vital signs management，pain mangagement，lifestyle mangagement，drug taking，transport and follow-up were summarized. Conclusion The best evidence for perioperative management of patients with aortic dissection summarized in this study is scientific and practical to a certain extent，which can provide evidence-based bases for medical staff to carry out the targeted evidence application，so as to better guide clinical practice and ensure patient safety.

Objective To investigate the effects of nasogastric tube（NGT） indwelling on postoperative pulmonary complications（PPCs） and prognosis in patients with cardiovascular surgery,in order to reduce PPCs and improve the patients’ prognoses. Methods Retrospective data of patients undergoing cardiovascular surgery in a tertiary hospital in Wuhan from July 2018 to November 2019 was conducted. The baseline data of patients in 2 groups were matched using a propensity score analysis. Results 316 patients were successfully matched,with 158 patients in the nasogastric tube indwelling group and 158 patients in the non-indwelling group. Compared with the patients in the NGT group without indwelling,the incidence of pulmonary infection,atelectasis,pneumothorax and respiratory failure was higher in the NGT group;the length of stay in the hospital and the length of stay in ICU were longer;the outcome was poor,with statistically significant differences（P<0.05）. Conclusion NGT indwelling is associated with the occurrence of pulmonary complications in patients with cardiovascular surgery,and it might prolong the length of stay and affect patient’s outcome.