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Table of Content

    15 February 2019, Volume 54 Issue 2
    Research Paper
    Consistency study of self-reports and nursing notes in adjuvant chemotherapy-related side effects among patients with breast cancer
    WU Bing,ZHANG Liuliu,ZHU Ping,WU Suya,LIU Jianhong,MENG Aifeng
    2019, 54(2):  165-169.  DOI: 10.3761/j.issn.0254-1769.2019.02.001
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    Objective To investigate and analyze the consistency between self-reports and nursing notes in adjuvant chemotherapy-related side effects among patients with breast cancer. Methods During July 2017 to July 2018,a total of 128 patients with first-time adjuvant chemotherapy after breast cancer surgery who were treated in a tertiary cancer hospital in Jiangsu Province were enrolled by convenience sampling method. Patients were investigated by general information questionnaire and self-reported questionnaire about chemotherapy-related side effects of breast cancer. At the same time,side effects information was also extracted from the electronic nursing notes to be compared with patient-reported data. Results The frequency and severity of chemotherapy-related side effects were consistently greater in patient-reported data than nurse-noted data(P<0.05). In addition to the side effect of “vomiting”,the consistency between patients and nurses was general,the consistency of other items was low. Conclusion Nurses tended to underreport or underestimate side effects,including several symptoms that may cause serious complications. In the future,patient-reported outcomes should be considered for integration into clinical practice in order to facilitate patient participation in decision-making and improve the medical experience.

    Construction and application of the enclosed loop system for nursing sensitive quality indicators in Tianjin
    ZHANG Huafu,SHEN Aomei,WANG Xianghua,CHEN Rongxiu,ZHAO Yue
    2019, 54(2):  170-174.  DOI: 10.3761/j.issn.0254-1769.2019.02.002
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    Objective To develop an enclosed loop system for nursing sensitive quality indicators in Tianjin in order to enhance nursing quality management. Methods Based on National Database of Nursing Quality Indicators,sensitive quality indicators were screened,and the enclosed loop system for nursing sensitive quality indicators in Tianjin was established,and further improved by training and feedback control. Results After implementation of the system,nursing adverse events and infection events in tertiary hospitals were reduced. Conclusion The enclosed loop system for nursing sensitive quality indicators in Tianjin can reduce the rates of nursing adverse events,infection events,and nurse turnover,which can provide reference for nursing quality improvement in other areas.

    Special Planning-Geriatric Nursing
    Design,development and application of safety and quality management information platform for gerontological nursing
    YU Mengying,PEI Caili,ZHANG Jun,WANG Yun,HE Guijuan
    2019, 54(2):  175-181.  DOI: 10.3761/j.issn.0254-1769.2019.02.003
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    Objective To design and develop quality management information platform for gerontological nursing safety,and evaluate the effects of application in order to improve quality management of nursing safety for elderly care. Methods Using safety quality index system for elderly care as the core,a platform with the function of learning and application of safety risk assessment,safety risk prevention,and adverse event report for gerontological nursing was designed and developed. Two medical institutions were selected to carry out a three-month platform application,and the effects of application were evaluated. Results The platform included four major modules. After the test of the platform was completed,14 safety high-risk items for gerontological nursing were identified. Nurses’ knowledge of safety for gerontological nursing was improved(t=4.941,P<0.001),and the incidence of adverse events for gerontological nursing was decreased( χ 2=5.860,P<0.05). Nurses’ satisfaction for the platform was 91.54%. Conclusion The platform could help to screen safety risks for gerontological nursing and enhance gerontological nursing quality,which is an effective tool of quality management for gerontological nursing safety.

    Construction of the content of preoperative nursing assessment for geriatric patients undergoing elective surgery
    XUE Dandan,CHENG Yun,ZHANG Yan
    2019, 54(2):  182-187.  DOI: 10.3761/j.issn.0254-1769.2019.02.004
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    Objective To construct the content of preoperative nursing assessment for geriatric patients undergoing elective surgery. Methods Based on the literature review,qualitative interviews and expert panel meetings,a two-round Delphi expert consultation was conducted to finalize the content. Results A total of 12 experts from geriatric nursing,clinical nursing,nursing management and geriatric medicine participated in the consultation. The average length of working was (28.17±5.05) years. The response rates of two-round consultation were 100%. Experts’authority coefficient was 0.89. The content of preoperative nursing assessment included 3 first-level indexes(general condition assessment,geriatric comprehensive assessment and surgery-related assessment),12 second-level indexes and 51 third-level indexes. Conclusion The content of preoperative nursing assessment is scientific and applicable which can guide standard assessment conducted by surgical nurses and provide reference for developing personalized perioperative care plan for patients.

    The current situation and influential factors of frailty in elderly patients with diabetes
    JIA Wenwen,ZHAO Huinan,DAI Fumin,ZHANG Hongmei,WANG Lijun,CHEN Ruiyun
    2019, 54(2):  188-193.  DOI: 10.3761/j.issn.0254-1769.2019.02.005
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    Objective To investigate the current situation of frailty and its influencing factors in elderly patients with diabetes so as to provide theoretical basis for clinical nursing intervention. Methods Totally 300 elderly patients with diabetes were selected from a tertiary hospital in Zhengzhou via convenience sampling method,and were investigated by self-designed general information questionnaire,TFI (Tilburg Frailty Indicator) and SDSCA(Scale of Diabetes Self-care Activities). Results Totally 296 valid questionnaires were collected. A total of 137 elderly patients with diabetes suffered from frailty and the prevalence was 46.3%. The mean score of total frailty was(5.26±2.87),and the scores for each dimension were as follows:physical frailty(2.79±2.08),psychological frailty(1.40±0.94)and social frailty(1.07±0.75). Multiple linear regression showed that comorbidity,self-management behavior,glycosylated hemoglobin,educational degree,polypharmacy and smoking were the major influential factors(P<0.05). Conclusion The prevalence of frailty in elderly patients with diabetes was at a high level,containing different degrees of physical,psychological and social frailty. Medical staff should attach great importance to the assessment of frailty among elderly patients with diabetes,take targeted and holistic interventions timely to prevent or delay the development of frailty.

    Current status and risk factors of “social hospitalization” among elderly stroke patients
    GU Chuer,PENG Gangyi,YING Wenjuan,SU Jing
    2019, 54(2):  194-198.  DOI: 10.3761/j.issn.0254-1769.2019.02.006
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    Objective To analyze the current status and risk factors of “social hospitalization” among elderly patients with stroke. Methods Retrospective survey was used to collect relevant data from 420 medical records of hospitalized elderly patients with stroke,from September 2015 to September 2016 in a tertiary hospital in Shantou. Logistic regression analysis was used to analyze the influencing factors. Results The rate of “social hospitalization” was 21.80% among investigated elderly patients with stroke,while their hospital medical expenses accounted for 39.64% of overall expenses and the length of stay accounted for 39.40%. Multiple logistic regression showed that hospital-acquired infection,and activities of daily living when meeting discharge criteria were risk factors for “social hospitalization”. Activities of daily living when meeting discharge criteria were correlated with length of stay and medical expenses(P<0.001). Conclusion Huge amounts of medical sources were consumed by “social hospitalization”. Reducing hospital-acquired infection,promoting early rehabilitation,improving activities of daily living when meeting discharge criteria will help reduce “social hospitalization”.

    Translation and reliability and validity testing of Chinese version of InterRAI Home Care
    TIAN Jiali,LIU Yu,ZHANG Su,WANG Wen,GONGYE Huijuan,ZHANG Xin
    2019, 54(2):  199-205.  DOI: 10.3761/j.issn.0254-1769.2019.02.007
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    Objective To translate the English version of InterRAI Home Care into the Chinese version and to evaluate its reliability and validity. Methods The translation and culturally adaptation of InterRAI Home Care were performed to construct the Chinese version of InterRAI Home Care. Using the convenience sampling,215 subjects who met eligibility criteria were recruited from community health care centers of Dongcheng District,Beijing. We used the Chinese version of InterRAI Home Care,Modified Barthel Index scale,Modified IADL scale,and Mini-Mental State Examination scale to assess the elderly. Results The Cronbach’s α of Chinese version of InterRAI Home Care was 0.871 which confirmed the internal consistency. The I-CVI was 1.0 for all items,and the S-CVI was also 1.0. The inter-rater reliability was confirmed by Pearson correlation coefficient which ranged from 0.916 to 0.942. The criterion-related validity was established by Pearson correlation coefficients which ranged from -0.999 to -0.810 between scores of the ADL and Modified Barthel Index scale. The criterion-related validity was established by Pearson correlation coefficients which ranged from -0.996 to -0.962 between scores of the IADL and Modified IADL scale. The criterion-related validity was established by correlation coefficient of 1.0 between cognitive disorder of CAPs and MMSE scale. The agreement coefficient was 1.0 between CAPs and doctors’ diagnoses. Conclusion The Chinese version of InterRAI Home Care was demonstrated to be reliable and valid among community dwelling elderly.

    Special Planning-Critical Care Nursing
    Construction of training curriculum system for ICU new nurses based on transition shock model
    XUE Youru,ZHANG Wei,SUN Gaoxiang,CHEN Mei,LIN Xiaohong,HE Lianghui,WU Huifen,GONG Jian
    2019, 54(2):  211-216.  DOI: 10.3761/j.issn.0254-1769.2019.02.009
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    Objective To construct training curriculum system for ICU new nurses based on transition shock model,so as to guide clinical nursing practice and evaluate training quality for ICU new nurses. Methods Based on transition shock model,the training curriculum system were established by literature review,expert group discussion,Delphi method and semi-structured interviews with 9 nursing staff. Results The rates of return of questionnaire in the first and second round expert consultation were 100% and 94.44%. The authority coefficient of experts was 0.890,and the coordination coefficient of experts’ opinion was 0.412. The system included 4 first-level indexes,17 second-level indexes,and 126 third-level indexes. Conclusion The results of the study is reliable and the system can provide reference for training of new nurses in ICU.

    Construction and preliminary application of restraint grading program based on evaluation of delirium in ICU patients
    LI Xiaozhen,DENG Wei,XU Lin,WANG Ying,JIANG Yinfen
    2019, 54(2):  217-223.  DOI: 10.3761/j.issn.0254-1769.2019.02.010
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    Objective To construct a restraint grading program based on evaluation of delirium in ICU patients and to explore the effects of application. Methods Convenience sampling method was used to recruit 416 ICU patients in our hospital. Patients were divided into two groups:the experimental group with 214 cases receiving restraint grading program,and the control group with 202 cases using Restraint Decision Wheel developed in Canada in 2006. The restraint grading program was developed by three rounds of Delphi consultation. Results There were significant differences in total length of restraint time,restraint time of three levels,and disease outcomes(P<0.05) between two groups. Meanwhile,no significant differences were identified in patient satisfaction,rate of unplanned extubation,and falling bed (P>0.05) between two groups. Conclusion The restraint grading program can reduce the restraint time,the rate and severity of restraint,improve the disease outcomes,and guarantee patients’ safety.

    The effect of the intervention program for relocation on relocation stress in family members of cancer patients transferred from ICU
    ZHAO Jing,CHEN Lei,LI Wenli,CHI Yuanyuan,YI Xiangli,QIANG Wanmin
    2019, 54(2):  224-229.  DOI: 10.3761/j.issn.0254-1769.2019.02.011
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    Objective To establish an intervention program for transferring ICU cancer patients,and to explore its effects on relocation stress of the family members. Methods A total of 52 family members of cancer patients who met the inclusion and exclusion criteria were recruited and divided into the intervention group(26 cases)and the control group(26 cases) randomly. Participants in the intervention group received relocation intervention program in addition to routine nursing,while the control group received routine nursing. Basic information questionnaire,the Family Relocation Stress Scale(FRSS),the State Anxiety Inventory(SAI) and the Family Caregiver Task Inventory(FCTI) were used to investigate relocation stress,anxiety and care ability of the families before and after the intervention. Results Differences in basic information,relocation stress,anxiety and care ability of patients and their family members were not statistically significant between the intervention group and the control group before intervention(P>0.05). After the intervention,there were significant differences between two groups in the total score of relocation stress and subscales of relocation stress,the degree of anxiety,the score of family care ability scale and its subscales(P<0.05). Conclusion The relocation intervention program can effectively prevent the level of relocation stress,reduce anxiety and improve the care ability of family members of cancer patients after ICU transfer.

    Best evidence summary for prevention strategies for ventilator-associated pneumonia(VAP) due to methicillin-resistant Staphylococcus aureus(MRSA)
    SHAN Jun,JI Yunlan,LEI Xiaoling,XU Huifen,WANG Linhua,WU Juan,LI Jingyi,SHEN Wangqin
    2019, 54(2):  230-234.  DOI: 10.3761/j.issn.0254-1769.2019.02.012
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    Objective To retrieve and analyze available evidence on prevention of ventilator-associated pneumonia(VAP) due to methicillin-resistant Staphylococcus aureus(MRSA) and summarize the best available evidence. Methods We searched the PubMed,Embase,Cochrane Library,BMJ-Clinical Evidence,BMJ-Best Practice,uptodate,Joanna Briggs Institute(JBI),Registered Nurses’ Association of Ontario(RNAO),National Guideline Clearinghouse(NGC),National Institute for Health and Care Excellence(NICE),and complementally searched CNKI,Wanfang Database,VIP Database and CBM published up until June 2018,to collect articles including guidelines,evidence summary(ES),best practice information sheet(BPIS),expert consensus,systematic review(SR) and original research. Three authors independently evaluated quality of literatures and extracted data. Results Nine articles were enrolled,including one Chinese language article and eight English articles;one experimental study,one cohort study,five SRs,one expert consensus,and one guideline. Best evidence included:mouth rinses with 15ml of 2% Chlorhexidine(CHX) digluconate for twice per day until discharge,bed bath with Chlorhexidine daily;active screening with nasal and pharyngeal swab culture for MRSA when admitted to ICU and within 24 hours,using mupirocin in the nostrils for MRSA colonized patients,protective isolation might be cancelled for hospitals with high levels of compliance with hand hygiene and standardized infection prevention strategy,cleaning and disinfection of hospital environment and medical equipments. Conclusion Health care providers should take strategies such as active screening for MRSA as patients admitted to ICU,decolonization,mouth rinses with CHX in early mechanical ventilation,and cleaning and disinfection of environment and equipments,to prevent MRSA-VAP.

    Specialist Practice and Research
    Analysis of the occurrence and influencing factors of delirium in terminal cancer patients
    FENG Qin,LI Ling,MA Wang,WANG Peng,LI Sisi,LIU Mengyue
    2019, 54(2):  238-243.  DOI: 10.3761/j.issn.0254-1769.2019.02.014
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    Objective To investigate the current status of delirium of terminal cancer patients,and to explore the influencing factors and provide evidence for clinical early assessment and screening. Methods Data of terminal cancer patients were collected from a hospice care unit from October 2016 to March 2018. Logistic regression model was used to analyze the independent influencing factors of delirium in terminal cancer patients. Results This study included 231 patients with 139 cases of delirium,and the incidence of delirium was 60.2%. Score of Eastern Cooperative Oncology Group(ECOG),Palliative Prognostic Index(PPI),medicine type(opioids,benzodiazepines,corticosteroids),polypharmacy(drug types≥3),symptom(infection,sleep disorder,constipation,hypoxia,cachexia),liver/kidney failure,electrolyte imbalance,brain metastasis,and immobilization were related to delirium(P<0.05);Logistic regression model showed that using opioids(OR=1.477),infection(OR=3.782),sleep disturbance(OR=4.209),and PPI(OR=6.285) were independent influencing factors of delirium. Conclusion The incidence of delirium of terminal cancer patients is still high. The use of opioids,infection,sleep disturbance,and PPI can cause delirium. Health staff should evaluate influencing factors early to decrease the incidence of delirium.

    The practice and evaluation of day surgery management for patients with benign breast lesions in the breast surgery ward
    LIU Changqing,REN Hongfei,ZHOU Qian,LI Jiping,GOU Juxiang,GONG Renrong
    2019, 54(2):  244-248.  DOI: 10.3761/j.issn.0254-1769.2019.02.015
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    Objective To explore the feasibility and effectiveness of day surgery management in breast surgery ward for patients with benign breast lesions. Methods To recruit 180 patients with benign breast lesions who underwent day surgery management in the department of breast surgery of our hospital as the experimental group,180 cases managed by routine inpatient surgery were selected as the control group. The experimental group adopted the management method of day surgery,of which the preoperative examination,health education,anesthesia consultation and other medical services of the patients were completed in advance in the outpatient department. A special medical and nursing team was set up to perform the day surgery management,the patients underwent the day surgery in the operating room with routine postoperative care and were discharged at 8:00 a.m. on the second day after surgery when the postoperative evaluation results met the discharge criteria. Results The surgery waiting time,hospitalization time and direct medical expenses of the experimental group were all less than those of the control group,with statistically significant differences(P<0.001). Patients’ satisfaction in the experimental group(100%) was higher than that in the control group(95%),and the difference was statistically significant(P<0.01). The incidence of postoperative complications in the experimental group(0.6%) was lower than that in the control group(2.8%),but the difference was not statistically significant(P>0.05). Conclusion It is feasible,safe and effective to perform day surgery management for patients with benign breast lesions in the breast surgery ward,which could also optimize the utilization efficiency of medical resources.

    Effect of individualized continuous follow-up management on treatment compliance and outcomes in patients with remote ischemic conditioning
    ZHAO Jie,CHANG Hong,ZHANG Jiajia,YAO Hui
    2019, 54(2):  249-253.  DOI: 10.3761/j.issn.0254-1769.2019.02.016
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    Objective To evaluate the effect of individualized continuous follow-up management in patients with remote ischemic conditioning(RIC) on compliance and treatment. Methods Using convenience sampling and historical control,patients received RIC from March to May 2017 were recruited as the control group,and those received RIC from June to September 2017 were recruited as the experimental group. The control group was provided with routine follow-up,whereas the experimental group was provided with individualized continuous follow-up management. Treatment compliance at 1,3,6 months,as well as recurrence rate of ischemic stroke events within 6 months for two groups were compared. Results The compliance in the experimental group was higher than that in the control group at 1,3,and 6 months,and the differences were statistically significant(P<0.001). The recurrence rate of the ischemic stroke in the control group was 5.66% which was higher than 0% in the experimental group,but the difference was not statistically significant(P>0.05). Conclusion Individualized continuous follow-up management can effectively improve the treatment compliance of patients undergoing RIC,thus ensuring the clinical research effect of RIC. This management method can provide reference for construction of RIC treatment and nursing model in the future.

    Nursing care of 143 infants with iron deficiency anemia treated with iron agent before operation
    XU Jianying,ZHU Jihua,XU Weize,YE Xiaoli
    2019, 54(2):  254-257.  DOI: 10.3761/j.issn.0254-1769.2019.02.017
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    This article summarized the nursing experience of 143 infants and children with iron deficiency anemia who received intravenous iron agent before operation. The key points of nursing included:proper preparation of liquid medicine,close observation of allergic reaction,rational selection of venous access,active prevention and treatment of phlebitis and leakage,and health education of iron treatment. All infants had no abnormal liver and kidney function during treatment,2 cases had increased heart rate,2 cases had phlebitis and 7 cases had pigmentation around the puncture site. These infants had normal heart rate,phlebitis was improved and pigmentation subsided after intervention. After intravenous iron treatment,the red blood cell count,hemoglobin,hematocrit,average red blood cell volume and average red blood cell hemoglobin of 143 infants increased significantly,and 112 received the surgery successfully after the iron treatment,while 24 continued the iron treatment,and 7 were lost to follow-up.

    Operative cooperation and nursing for invasive cardiopulmonary exercise test in 7 cases
    CHEN Wenli,JI Mingjian,HONG Cheng,WANG Tao,GAO Yi,HUANG Xiufen,HE Wenjun
    2019, 54(2):  258-260.  DOI: 10.3761/j.issn.0254-1769.2019.02.018
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    This article explored key points of operative cooperation and nursing for invasive cardiopulmonary exercise test and provided reference for clinical nursing practice. All patients underwent invasive cardiopulmonary exercise tests due to unknown causes of dyspnea. Key points of nursing included:check the key test results before the examination,fully evaluate activity endurance,and assist the optimization of the exercise program,strength catheter management during the examination to avoid postoperative complications,make clear of division of labor,properly arrange and place all kinds of instruments and first-aid items to ensure timely first-aid,perform whole-procedure psychological care to improve sense of safety and relieve anxiety,pay attention to exercise-induced oxidative stress after examination,control speed of infusion to avoid complications such as arrhythmia and heart failure.Three patients were found to have exercise-induced pulmonary hypertension,1 patient had metabolic dysfunction,while the rest of 3 patients had no abnormal results. During the examination,1 patient developed pulmonary embolism,1 patient developed arrhythmia after the examination,and the rest successfully completed the examination.

    Nursing Management
    Analysis of adversity quotient level and its influencing factors of male nurses in tertiary hospitals in Henan Province
    LI Bo,ZHANG Qianqian,ZHANG Li,FAN Chaolin,YAN Wenrun,ZHANG Zhenzhen,JIN Wanwan,LIU Yanjin
    2019, 54(2):  261-264.  DOI: 10.3761/j.issn.0254-1769.2019.02.019
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    Objective To investigate the adversity quotient level of male nurses in tertiary hospitals in Henan Province and to identify the influencing factors. Methods Totally 152 male nurses from five tertiary hospitals in Henan Province were surveyed using general information questionnaire,Adversity Quotient Scale and Simplified Coping Style Questionnaire(SCSQ). Single-factor and multiple linear regression were conducted to explore influencing factors. Results The score of male nurses’ adversity quotient was(134.59±10.97). The scores of Adversity Quotient Scale of control and attribution dimension were (35.13±4.23) and (34.11±3.48),respectively. Multiple linear regression analysis showed that job title,department of working,whether they were the only child,and form of employment contract were influencing factors of adversity quotient(P<0.05). Pearson’s correlation analysis showed that the score of adversity quotient of male nurses was positively correlated with positive response and negatively correlated with negative response(P<0.001). Conclusion The adversity quotient of male nurses was at the middle level in tertiary hospitals in Henan Province. Male nurses who were with job titles as senior nurse or higher,non-single child,working in ICU,with contract as formal permeant staff,had relatively high adversity quotient. The level of adversity quotient was strongly associated with coping style.

    The current status of the curriculum for doctoral education in nursing in China:a national survey
    ZHANG Libing, LIU Lin, ZHANG Bing, JIANG Anli
    2019, 54(2):  265-269.  DOI: 10.3761/j.issn.0254-1769.2019.02.020
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    Objective To investigate the current status of the curriculum for doctoral education in nursing in China,which will provide a reference for further optimizing the curriculum design for doctoral nursing education. Methods This research adopted questionnaire survey to investigate the curricula of doctoral education in nursing in 26 schools of nursing. Results The curricula of doctoral education in nursing varied in design,most of which included the common courses,specialized courses and elective courses. Among those 26 schools of nursing,the average number of courses was 15.42. The minimum academic credits of each school were different widely,and the average was 21.29. The main contents of curricula included political education,basic theories,research methodology,research direction,latest development,and academic writing. However,the specialized course on nursing was relatively less,with only 2.38 courses were offered averagely,and nine schools of nursing had not offered such kind of courses yet. Conclusion The current doctoral education in nursing in China has not established curriculum system with nursing science features,and lacked standards for setting up core courses of nursing. Great importance should be attached on constructing nursing specialized courses,and determine rational number and proportion of academic credits. Meanwhile,relevant administrative departments of education should also clarify the core courses,so as to further optimize the curriculum design of doctoral education in nursing.

    PICC catheterization and nursing of 6 neonates with persistent left superior vena cava
    WANG Bihua,WAN Xingli,HUANG Xi,HU Yanling,SU Shaoyu,LI Xiaowen,LIU Chunhua,HE Xuemei,CHENG Hong,CHEN Qiong
    2019, 54(2):  270-273.  DOI: 10.3761/j.issn.0254-1769.2019.02.021
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    The PICC catheterization and post-catheterization nursing of 6 neonates with persistent left superior vena cava were conducted. Key points of care included:choose the right time to insert the catheter;the image data of neonates were analyzed retrospectively before catheterization;measure the length of body surface correctly;under the guidance of ultrasound, the tip of the PICC catheter was indwelled in the lower third of the persistent left superior vena cava;the use of PICC catheters should be closely observed,early identification of PICC-related complications and appropriate treatment;establish special case files to ensure the safe use of PICC in neonates with persistent left superior vena cava. Six cases of PICC were scheduled to be removed after 10-21 days of indwelling,no PICC-related complications occurred during the indwelling period.

    Comparison on the changes of tracheal sealing effects of two shapes of direct and indirect measurement procedures with cuffs
    HUANG Ling,CHEN Ying,ZHANG Lifeng,MENG Liying,ZHOU Chunfeng,LIN Jing,LI Yang,HUANG Bing
    2019, 54(2):  274-276.  DOI: 10.3761/j.issn.0254-1769.2019.02.022
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    Objective To compare the sealing effects of direct and indirect pressure measurement methods on cuffs with taper and columnar shapes. Methods Cuffs were divided into the taper and columnar shapes,both groups were measured using direct and indirect measurement procedures,and the fluid leakage of two groups were observed. The direct measurement method monitored pressure by a directly linked handheld pressure gauge,while the indirect measurement method added a 3-way stopcock between the handheld pressure gauge and the cuff. We locked the 3-stopcock to stabilize handheld pressure gauge reading at 32 cmH2O before measure the pressure. Results The pressure of the taper shaped cuffs in direct measurement group was(21.73±0.30) cmH2O while the pressure of column shaped cuffs was(25.01±0.13) cmH2O,which showed a statistically significant difference (P<0.01). Fluid on the two types of cuffs all leaked after direct measurement. The pressure of the taper shaped cuffs in indirect measurement group was(31.08±0.31) cmH2O,and(31.10±0.17) cmH2O in columnar shape,without significant difference(P>0.05). Fluid on the taper shaped cuffs didn’t leak after indirect measurement procedures yet the fluid on column shaped cuffs all leaked. Conclusion The direct measurement method can cause pressure decreasing in taper and column shaped cuffs as well as fluid leakage. Indirect measurement method can lose only 1~2 cmH2O of pressure for taper and column shaped cuffs,and the taper shaped cuffs can seal fluid leak effectively.

    Evidence Synthesis Research
    Evidence summary for prevention and management of deep venous thrombosis after spinal surgery
    MI Yuanyuan,CHEN Ting,ZHOU Yingfeng,KE Hui,ZHANG Yue,ZHOU Lijun,LUO Jiangmin,YAN Rong,LIU Yunfang,ZHAO Shiyu,LI Suyun
    2019, 54(2):  288-294.  DOI: 10.3761/j.issn.0254-1769.2019.02.026
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    Objective To select and obtain the best evidence for deep venous thrombosis(DVT) prophylaxis in spinal surgery patients after operation so as to provide reference for clinical practice to decrease the rate of DVT. Methods Using the method of evidence-based nursing,clinical question of DVT prevention in spinal surgery patients was raised. Relevant research was retrieved by computer search. JBI evidence appraisal and recommendation system were used to evaluate quality of studies and level of evidence. Results Combined with judgment of clinical professionals,totally 27 evidences selected,including DVT assessment,diagnosis and screening,intervention strategies,prevention time and methods,health guidance,etc. Conclusion This study summarized the best evidence for prevention and management of deep venous thrombosis after spinal surgery,and help clinical nurses and nursing admi-nistrators decision-making,ultimately through adapting the best evidence and using scientific nursing methods to solve the clinical problems and improve nursing quality.