Objective To construct a telemedicine-based home care program for hospice patients that will provide a reference for hospice telemedicine-based home care practices. Methods Using the Supportive Care Model as a theoretical guide，a preliminary telemedicine-based home care program for hospice patients was developed based on literature research combined with qualitative interviews. 2 rounds of expert consultation were conducted in March 2023 to solicit their opinions and revise the proposal to form the final draft. In April 2023，9 patients who were about to be discharged from the palliative care ward of a cancer hospital in Hunan Province，were selected for the preliminary application of the program by the convenience sampling method；the number of cases of adverse events and the Telemedicine Satisfaction Questionnaire were used for the effectiveness of the program. Results A total of 16 experts completed 2 rounds of consultation，and the coefficient of expert authority was 0.928. The effective questionnaire recovery rates of the 2 rounds of consultation were 94.12% and 100%；the expert opinion submission rates were 100% and 25.00%；the coefficients of variation of item scores were 0.05~0.18 and 0~0.16. The coefficients of Kendall harmony in 2 rounds were 0.093 and 0.210（P<0.001）. The constructed final program included 4 dimensions of symptom management，daily life care，psycho-spiritual care and social information support，and a total of 17 modules such as pain management，dyspnea management，gastrointestinal symptom management and cough management，which covering 37 specific items. No adverse events occurred during the application and the score of care satisfaction was（60.22±7.41），which indicated a high level of satisfaction. Conclusion The program constructed in this study is scientific，relevant and feasible，and can provide guidance for healthcare professionals in conducting hospice telemedicine-based home care practices.

Medication therapy is the main treatment for adolescent chronic disease patients. Insufficient medication literacy will not only reduce their medication compliance，but also may lead to adverse medication events. This article reviewed the concept，status quo，harm of insufficient medication literacy，related influencing factors and intervention strategies of adolescent chronic disease patients，aiming to provide references for improving medication literacy of patients and ensuring medication safety.

Objective To retrieve，evaluate and integrate evidence related to subcutaneous injection technique of low molecular weight heparin. Methods The clinical decisions，recommended practices，evidence summaries，technical reports，guidelines，expert consensuses，and systematic evaluations on the subcutaneous injection of low molecular weight heparin in domestic and foreign databases and related professional websites were searched by computer. The evidence was extracted and summarized according to the subject after the independent literature quality evaluation by 2 researchers. The literature retrieval time limit was from the establishment of the database to November 2021. Results According to the inclusion criteria，9 pieces of literature were screened，including 2 evidence summaries，2 expert consensuses，and 5 systematic reviews. Through literature reading，evidence extraction and classification，a total of 12 pieces of evidence were summarized，including preparation before injection，skills during injection，and post-injection disposal. Conclusion This study summarized the best evidence of subcutaneous injection techniques of low molecular weight heparin，so as to provide references for nurses to carry out clinical practice. Nurses should carefully select and apply evidence in combination with clinical situations and patients’ wishes，so as to ensure injection safety and reduce the incidence of related complications.

Objective To form an expert consensus on family meeting in palliative care and provide references for the staff engaged in palliative care to implement family meeting. Methods A consensus drafting group was set up to systematically search，evaluate and extract evidence related to family meeting in palliative care to form a draft consensus. After 2 rounds of Delphi expert consultation and expert demonstration meetings，expert opinions were sorted out and analyzed，the rough draft was revised，and then the final consensus draft was formed. Results The positive coefficient of the first round of expert consultation was 92.11%，and the second round was 100%. The coefficient of expert judgment was 0.95；the degree of familiarity was 0.89；the degree of authority coefficient was 0.92. The Kendall’s coefficients of the 2 rounds of consultation were 0.157 and 0.253，which were statistically significant（P<0.001）. The final consensus consisted of 8 aspects，including the scope，terms and definitions，basic requirements，timing of family meetings，preparation before meetings，implementation of meetings，records and follow-up，and precaution. Conclusion The consensus is practical，and it can provide guidance for the standardized implementation of family meeting in palliative care.

Objective To construct an early activity program for children with mechanical ventilation,and to explore the safety and efficacy of its clinical application. Methods On the basis of literature analysis,the early activity program was constructed. The convenience sampling method was used to select 50 cases of 3~14-year-old children with mechanical ventilation into an experimental group from December 2020 to July 2021 at the pediatric intensive care unit（PICU） of a tertiary children’s hospital in Hunan province. A nurse-led early activity program was implemented on the basis of the routine nursing. 50 children admitted from April 2020 to November 2020 were selected into a control group,and the routine nursing was given. The heart rate,respiration,systolic blood pressure and oxygen saturation of the experimental group were collected 5 mins before the activity,at the 15th min of the activity and 5 mins after the activity,as well as the occurrence of adverse events such as unplanned extubation,falling and bed falling during the activity. Meanwhile,the completion rate of the early activity program was calculated to evaluate the safety and feasibility of the early activity. Muscle strength level,incidence of delirium,duration of mechanical ventilation and duration of PICU were compared between the 2 groups on day 1,day 3 and day 6,and the effect of the early activity program was evaluated. Results There were no statistically significant differences in heart rate,respiration and blood oxygen saturation of the experimental groups at 5 mins before the activity,at the 15th min of the activity and 5 mins after the activity（P>0.05）,while there were statistically significant differences in systolic blood pressure（P<0.001）. There were no unplanned extubation,fall and bed falling during the activity. The overall completion rate of the early activity program was 86.96%. There was no significant difference in muscle strength between the 2 groups on day 1 and day 3 （P>0.05）,and the muscle strength of the experimental group was higher than that of the control group on day 6（P<0.001）. The incidence of delirium in the experimental group was lower than that in the control group,and the time of mechanical ventilation and PICU stay were both shorter than that in the control group,with statistically significant differences（P<0.05）. Conclusion The early activity program for children with mechanical ventilation is safe and feasible,which can improve the muscle strength level of children,reduce the incidence of delirium,shorten the time of mechanical ventilation and PICU stay,and contribute to the early recovery of children.

Objective To explore the application effect of Head Nurse Listening Day,in order to seek scientific and reasonable interventions to improve the psychological resilience of pediatric nurses,to promote the organizational climate among nurses,and to reduce the occurrence of recessive absenteeism.Methods In 2018,our hospital carried out lean 10S management. The cluster random sampling method was utilized to enroll 87 nurses as research subjects from the neurology department,hematology department and rehabilitation department where pediatric patients with chronic diseases were hospitalized. The subjects were randomly allocated into a control group （45 nurses） and a trial group（42 nurses）. From January to December 2018,a group was set up to carry out Head Nurse Listening Day with Listening-Relief-Interaction as the main contents. A baseline survey was conducted by a set of instruments,including Conner-Davidson Resilience Scale（CD-RISC）,Nurse Organizational Climate Perception Scale,and Stanford Presentation Scale（SPS-6）. A two-to-two correlation analysis of 3 scales was used,and then the Head Nurse Listening Day was launched. The 2 groups of nurses were reinvestigated in December 2018 by above 3 scales and the results were compared with these of the baseline survey.Results The CD-RISC scores were positively correlated with the scores of Nurse Organizational Climate Perception Scale before and after the intervention,and they were negatively correlated with the SPS-6 scores. The SPS-6 scores were negatively correlated with the scores of Nurse Organizational Climate Perception Scale,and the differences were statistically significant（P<0.05）. The scores of CD-RISC and Nurse Organization Climate Perception Scale after intervention were better than those before,and the SPS-6 scores were lower than these after intervention,and the differences were statistically significant（P<0.05）.Conclusion The application of Head Nurse Listening Day can improve the psychological resilience and the organizational climate,and reduce the incidence of recessive absenteeism among pediatric nurses.

Objective To explore the current status and influencing factors of health education literacy of clinical pediatric nurses in China,so as to help clinical managers to formulate targeted training programs and provide references for the improvement of health education literacy of clinical nurses. Methods Pediatric nurses from 31 provinces and cities at all levels in the country were selected as survey subjects by the method of general survey,and a self-made “Pediatric Nurse Health Education Literacy Questionnaire” was distributed to investigate the knowledge,attitude and practice of health education literacy of nurses. The influencing factors of health education literacy were analyzed by multiple linear regression method. Results A total of 15,800 questionnaires were collected,of which 15,765 were valid with an effective recovery rate of 99.78%. 31 provinces,autonomous regions and municipalities nationwide participated in this survey. The knowledge of health education literacy of nationwide pediatric nurses scored（37.80±4.46）;the score of attitude was（31.74±3.60）;the practice scored（77.03±7.76）. Multiple linear regression analysis showed that professional titles,related publications,and the attendance of related trainings were main influencing factors of health education literacy of pediatric nurses（P<0.05）. Conclusion The health education literacy of pediatric clinical nurses in China was at a medium level,which needs to be further improved. Active participation in various forms of training could help nurses form a complete framework of health education and improve the holistic level of health education literacy. Nursing managers should provide effective trainings for nurses based on clinical needs and make joint efforts to improve the health education literacy of pediatric clinical nurses.