Chinese Journal of Nursing

Evidence-based practice of target temperature management in patients with traumatic brain injury

MENG Xiaojing, LI Xiang, FENG Yingpu, FAN Jingli, HUO Xiaoran, ZHANG Chunxia, ZHOU Limin, GAO Min

2023, 58(19): 2309-2318. DOI: 10.3761/j.issn.0254-1769.2023.19.001

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Objective To apply the best evidence of target temperature management in patients with traumatic brain injury to clinical practice and to evaluate its effect. Methods Followed the application model of JBI evidence-based nursing center，16 review indicators were developed based on the best evidence，and the evidence-based continuous quality improvement model was taken as the theoretical framework. From June 2021 to April 2022，the evidence-based practice was applied to patients with traumatic brain injury in neurosurgery ICU according to the baseline review，practice change and review of change effect after evidence application，and the implementation rate，target temperature management related knowledge level，evidence-based ability，patient complication rate and organizational culture level were compared. Results After evidence-based practice，the implementation rates of the first and second rounds of reviews for various review indicators have improved compared to the baseline，with significant increases in the implementation rates of review indicator 2，3，7，8，9，10，11 and 13（P<0.05）. There was a significant decrease in the incidence of grade 3 chills in the 3 groups of patients before and after the baseline review，the first review，and the second review（χ²=7.680，P=0.021）. Before and after the implementation of the baseline review，the first round of review，and the second round of review，the scores of the nurses’ knowledge status questionnaire on target temperature management for patients with traumatic brain injury，and the evidence-based practice influencing factors questionnaire were all improved（F=3.827，P=0.025；F=4.997，P=0.009），while the scores of the nurses’ evidence-based nursing practice obstacle scale were lower than those before the implementation（F=4.174，P=0.018）. The level of organizational culture has improved compared to it before implementation（F=7.421，P=0.024）. Conclusion Through the continuous improvement of evidence-based practice，target temperature management for patients with traumatic brain injury in neurosurgery ICU can effectively standardize the diagnosis and care behavior of medical staff and reduce the incidence of patients’ complications，but it still needs continuous quality supervision and review in the later stage.

Evidence-based practice of perioperative dietary management of patients undergoing fiberoptic bronchoscopy under general anesthesia

LI Yaxin, SHAO Hongyan, AN Yantao, ZHANG Zhenxia, WANG Feifei

2023, 58(19): 2319-2325. DOI: 10.3761/j.issn.0254-1769.2023.019.002

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Objective Evidence-based nursing practice based on the best evidence of perioperative dietary management in patients undergoing fiberoptic bronchoscopy under general anesthesia was carried out and its application was evaluated. Methods From July 2021 to March 2022，the Joanna Briggs Institute（JBI） clinical evidence practice application model was conducted at the Department of Respiratory and Critical Care Medicine at our hospital to develop review metrics for baseline review based on the best evidence obtained previously，and barriers were analyzed，and the best clinical decisions for clinical application were developed，followed by 2 rounds of clinical reviews. The level of knowledge and the implementation rate of review indicators of 49 healthcare professionals in patients undergoing fiberoptic bronchoscopy under general anesthesia were compared before the application of evidence（98 patients），the first round review after the application of evidence（73 patients），and the second round review after the application of evidence（59 patients）. The duration of preoperative and postoperative fasting，the incidence of choking，thirst，hunger，nausea or vomiting were also compared. Results After the application of the evidence，the level of knowledge of healthcare professionals was improved；the length of perioperative fasting was significantly shortened；the difference in the sense of thirst and hunger was statistically significant；the difference in the incidence of choking，nausea and vomiting was not statistically significant，and the implementation rate of the 13 reviewed indicators increased from 0~89.80% to 81.36%~100%，with significant differences in the implementation rate of the remaining 12 reviewed indicators，except for indicator 2 and 13（P<0.001）. Conclusion Evidence-based practice of perioperative diet management in patients undergoing fiberoptic bronchoscopy under general anesthesia can help to shorten the duration of perioperative fasting and improve patients’ discomfort，and it can be promoted in clinical practice.

Differences between fall risk and fall risk perception among hospitalized elderly patients

YANG Xin, YAO Meiqi, ZHANG Yuping, SHEN Xuhui, BAO Guanjun, BI Yan, GUO Zhiting, CHEN Haotian

2023, 58(19): 2326-2332. DOI: 10.3761/j.issn.0254-1769.2023.019.003

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Objective The differences between fall risk and risk perception of hospitalized elderly patients were analyzed to provide references for improving fall assessment strategies，improving the accuracy of fall perception of hospitalized elderly patients，and accurately preventing falls. Methods A total of 468 hospitalized elderly patients in Zhejiang province were recruited from December 2022 to February 2023. The general information questionnaire，the Fall Risk Perception Scale for Older Adults and Morse Fall Scale were used to investigate the difference between fall risk and risk perception. Results In this group，the fall risk was 45.0（30.0，55.0），showing a high level，and the fall risk perception was 62.5（47.3，75.0），showing a medium level. There was no significant difference in the risk perception scores of hospitalized elderly patients with different risk levels（H=4.048，P>0.05）. There were 169 cases（67.6%） of under-perception in the high-risk group，38 cases（32.8%） of under-perception in the middle risk group，35 cases（30.2%） of over-perception in the middle risk group，and 66 cases（64.7%） of over-perception in the low risk group. The factors affecting fall risk and risk perception are basically similar. Univariate analysis showed that age，smoking，drinking，vision，activity pattern，sleep，medical payment and fall history in the last 3 months were influencing factors of fall risk in hospitalized elderly patients（P<0.05），and age，education level，drinking，sleep and fall history in the last 3 months were influencing factors of fall risk perception in hospitalized elderly patients（P<0.05）. The main difference was that education was related to risk perception，but not to fall risk. Conclusion Elderly hospitalized patients have a higher risk of falling，and there are problems of fall perception bias. It is suggested that in the prevention of falls，it is not only necessary to evaluate the fall risk of elderly hospitalized patients，but also to evaluate the perception of their own risk，so as to achieve individualized and precise protection.

A comparative study of risk prediction models for venous thromboembolism in elderly patients with lung cancer

MEI Yin, HUANG Lixue, LIU Ye, CHEN Wei

2023, 58(19): 2333-2338. DOI: 10.3761/j.issn.0254-1769.2023.019.004

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Objective To compare the predictive performance of 4 risk assessment models for venous thromboembolism（VTE） in elderly patients with lung cancer. Methods We prospectively and consecutively recruited lung cancer patients aged ≥60 years who were admitted to the Department of Respiratory and Critical Care Medicine of Beijing Hospital between January 2020 and June 2022，and followed up them for VTE within 6 months after enrollment. Caprini score，Padua score，Khorana score and COMPASS-CAT score were used to evaluate the risk of VTE of each patient，and then they were divided into a low-medium risk group or a high-risk group based on the cut-off value of each score. We compared the rates of VTE in the follow-up period between both groups. The area under receiver operative characteristic（AUC） was used to evaluate the predictive performance of the 4 models for long-term VTE in elderly patients with lung cancer. Results A total of 111 elderly patients with lung cancer were enrolled. The mean（±SD） age was（70.9±7.1） years；31（27.9%） were women；92（82.9%） were patients with non-small cell lung cancer. 20（18.0%）patients developed VTE within 6 months after enrollment. There were no significant differences in age，gender，BMI and comorbidity between the VTE group and the non-VTE group. The incidence of VTE in high-risk group assessed by Caprini score was significantly higher than that in medium-risk group. The incidence of VTE in high-risk group assessed by Padua score was significantly higher than that in low-risk group. However，the incidences of VTE in high-risk group assessed by Khorana and COMPASS-CAT scores were numerically higher than that in the corresponding comparative group（all P>0.05）. The AUC for VTE in Padua score，Caprini score，Khorana score and COMPASS-CAT score were 0.805（95% CI：0.672~0.937），0.757（95% CI：0.643~0.871），0.552（95%CI：0.401~0.704），and 0.515（95%CI：0.356~0.673），respectively. Conclusion Elderly patients with lung cancer had a high incidence of long-term VTE，and a risk predictive model is urgently needed to identify high-risk patients. Compared with Caprini score，Khorana score，and COMPASS-CAT score，Padua score showed a better ability in predicting the risk of VTE among elderly patients with lung cancer.

A survey and analysis on current status of the need and service for geriatric nursing in Sichuan Province

LIU Li, ZHANG Shuai, HU Xiuying

2023, 58(19): 2339-2344. DOI: 10.3761/j.issn.0254-1769.2023.019.005

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Objective To analyze the current situation of nursing needs and services for the aged in Sichuan province，so as to provide references for improving and standardizing nursing needs assessment and services for the aged. Methods The data of geriatric nursing needs assessment carried out by Sichuan Provincial Health Commission were used. The elderly aged 65 years and over were selected as the research subjects. The ability classification of the elderly，the number of geriatric syndromes，the level of nursing needs，whether to provide nursing services，and the items of nursing services were included in the descriptive analysis. Results A total of 1 272 896 elderly people were enrolled，of which 962 607（75.62%） were in 0 grade（good ability）. The number of cases of geriatric syndromes were 0-2，which accounted for the majority. A total of 310 289 elderly people had different degrees of nursing needs，and 129 097 elderly people were provided with nursing services by nursing staff，accounting for 41.6%. The highest proportion of the 4 types of nursing services were safety protection and guidance，health education，psychological communication and counseling，and traditional Chinese medicine diet care. Conclusion The nursing needs level of the elderly in the community is mainly intact，and the number of geriatric syndrome projects is mostly 0~2. The supply of nursing services for the elderly with nursing needs is seriously insufficient，and the supply of nursing services for the elderly needs to be standardized and improved.

The assessment and influencing factors of hospital-acquired functional decline in elderly cardiac surgery patients

SHEN Peiye, LAN Lan, WANG Jiaqi, WANG Junhui, SHEN Xinyi, CHEN Xiaomin, YAO Jinlan

2023, 58(19): 2345-2352. DOI: 10.3761/j.issn.0254-1769.2023.19.006

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Hospital-acquired functional decline is common in elderly patients undergoing cardiac surgery，and it is closely related to a variety of adverse outcomes. This article reviews the current situation，adverse prognosis，assessment tools，assessment timing and influencing factors of hospital-acquired functional decline in elderly patients undergoing cardiac surgery，and also makes recommendations for further improvement of hospital-acquired functional decline，in order to provide a reference for clinical medical and nursing staff to explore suitable assessment tools，early identify the risk of hospital-acquired functional decline in elderly patients undergoing cardiac surgery and formulate personalized rehabilitation interventions.

Research progress of cognitive frailty risk prediction models in the elderly

ZHAO Hua, LIU Xiaoling, LU Wenyan, XIA Jiangliu, ZHU Lingling, MA Yan

2023, 58(19): 2353-2357. DOI: 10.3761/j.issn.0254-1769.2023.19.007

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As one of the subtypes of frailty，cognitive frailty is reversible and can effectively predict negative health events in older adults such as dementia，disability，and functional decline. This article introduces the basic information about the universal cognitive frailty risk prediction model and disease-specific cognitive frailty risk prediction model，analyzes and compares the research methods and inclusion of risk factors in the cognitive frailty risk prediction model，and provides insights into the future，in order to provide references for medical and nursing staff to early identify the risk of cognitive frailty in older adults and provide effective intervention measures.

Research progress of assessment tools for anxiety about aging

XU Dandan, LI Xiaohan

2023, 58(19): 2358-2363. DOI: 10.3761/j.issn.0254-1769.2023.019.008

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Anxiety about aging plays an important role in the development of the gerontological nursing and the construction of a healthy aging society. This article reviews the development，contents，reliability，validity，and application of assessment tools for anxiety about aging at home and abroad. By analyzing the characteristics and limitations of each tool，it can provide a reference for the development and usage of localized measurement tools. It also provides the basis for accurate assessment of anxiety about aging and for the formulation of effective intervention strategies.

Application of a multi-component exercise program in patients with major neurocognitive disorders

JIN Qun, HUANG Lihua, HU Yue, YAO Chunnü, HU Mengqian

2023, 58(19): 2364-2372. DOI: 10.3761/j.issn.0254-1769.2023.19.009

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Objective To explore the application and effect of Vivifrail multi-component exercise intervention program in patients with major neurocognitive disorders. Methods In this quasi-experimental study，52 patients with major neurocognitive disorders who were hospitalized in a municipal psychiatric hospital from June 2021 to June 2022 were selected as research subjects and divided into Ward A as the intervention group（26 cases） and Ward B as the control group（26 cases）. The control group was treated with routine nursing，and the intervention group was treated with 12-week Vivifrail multi-component exercise on the basis of routine nursing. Short Physical Performance Battery（SPPB），Timed "Up and Go" Test（TUGT），6 Minutes Walking Test（6MWT） and Chair Sit and Reach（CSR） were used to evaluate physical function in both groups before and after intervention. Results After 12 weeks of intervention，the total score of SPPB（t=-4.312，P<0.001） and its 3 test dimensions-balance test（t=-3.029，P=0.004），4 m walking speed test（t=-3.972，P<0.001），chair standing test（t=-2.912，P=0.005），and CSR test results （t=-3.446，P=0.001） were significantly different between the 2 groups. The results of repeated measures analysis of variance showed that all the indexes in the 2 groups had interaction effects（P<0.001）. Except for the 4 m walking test of SPPB，the time effects of other indexes were statistically significant（P<0.05），and the variables with statistical significance of intergroup effect included balance test of SPPB and CSR test（P<0.05）. Conclusion Vivifrail multicomponent exercise can significantly improve the balance function，walking speed，muscle strength and flexibility of patients with major neurocognitive disorders in medical institutions，but the improvement of body flexibility and heart and lung function was not obvious.

The influence of healthy lifestyle on the risk of re-hospitalization in patients with chronic heart failure in Qinghai-Tibet Plateau

MA Xiaoting, WANG Mian, XU Wenbing, SHAN Haiyun, MA Ailing, MA Xiaojing, FAN Linlin, FAN Jingchun, XU Rui

2023, 58(19): 2373-2379. DOI: 10.3761/j.issn.0254-1769.2023.19.010

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Objective To explore the influence of healthy lifestyle on the risk of re-hospitalization in patients with chronic heart failure（CHF） at high altitude in Qinghai Province and provide scientific evidence for formulating targeted intervention countermeasures. Methods A total of 1 280 patients with CHF from December，2019 to October，2021 were enrolled in 4 tertiary hospitals in Qinghai Province. General data questionnaire and self-made healthy lifestyle questionnaire were used. The healthy lifestyle questionnaire contains 7 dimensions，including non-smoking and alcohol control，regular exercise，reasonable diet，anxiety-depression，healthy body mass index（BMI），good sleep，social support. Among which the anxiety and depression dimensions were measured by the Hospital Anxiety and Depression Scale（HAD），and social support was evaluated using the Medical Outcomes Study Social Support Survey（MOS-SSS）. The effects of different healthy lifestyles on the risk of re-hospitalization according to the re-hospitalization outcomes within 6 months were analyzed in the re-hospitalization group and non-re-hospitalization group. Results 107 invalid questionnaires were removed and there were 77 lost follow-up cases；1096 patients with CHF were finally included in the study，of which 599 patients were re-hospitalized within 6 months. There was no significant difference in the general data between the re-hospitalization group and the non-re-hospitalization group （all P>0.05）. Univariate and multivariate Logistic regression analysis showed that some variations would increase risks of re-hospitalization，and they were listed by OR rankly as smoke（OR=2.362），alcohol（OR=1.866），irregular exercise（OR=1.599），poor sleep quality（OR=1.481），improper diet（OR=0.476），anxiety（OR=1.158），depression（OR=0.955），low social support（OR=0.965）. Conclusion The lifestyle of CHF patients in the plateau area of Qinghai Province is not ideal，and maintaining a healthy lifestyle can reduce the risk of re-hospitalization in CHF patients. Medical staff should focus on the population with unhealthy lifestyle，and formulate targeted intervention strategies according to individual lifestyle characteristics，so as to improve the re-hospitalization rate and reduce medical costs.

The prevalence and contributing factors of impaired awareness of hypoglycemia in people treated with insulin for diabetes mellitus

YU Xiaohui, ZHANG Xinqiong, FAN Min, YANG Shengju, WANG Miaomiao, ZHANG Zhen, JIANG Huanhuan

2023, 58(19): 2380-2386. DOI: 10.3761/j.issn.0254-1769.2023.19.011

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Objective To investigate the hypoglycemic awareness status of insulin-treated people with diabetes and to analyze its influencing factors. Methods A total of 251 individuals with insulin-treated diabetes in the endocrine wards and diabetic physical examination centres of 2 comprehensive hospitals in Anhui Province were recruited as respondents from June to September 2022. General information questionnaire，Gold score and Clarke questionnaire，Edinburgh symptom scale，attitudes to awareness of hypoglycemia questionnaire，hypoglycemia confidence questionnaire and ways of coping questionnaire were used for assessment. Multivariate regression analysis was used to investigate the independent influences on hypoglycemia awareness，based on the results of univariate and correlation analyses. Results The prevalence of impaired awareness of hypoglycemia（IAH） ranged from 28.7% to 31.5%. Regression analysis showed that hypoglycemic symptom experience，hypoglycemic confidence and attitudes to awareness of hypoglycemia contributed independently to IAH（P<0.001），in total accounting for 44.3% of the variation in hypoglycemia awareness. Conclusion The hypoglycemic awareness state in diabetes is influenced by a combination of factors and deserves further attention and research. Healthcare providers should focus on identifying and quantifying hypoglycemic awareness states and assessing hypoglycemic symptoms，guiding or modifying individuals to form correct hypoglycemic cognitive beliefs，and helping patients improve their hypoglycemic coping skills and ultimately to reverse IAH outcomes.

Current status of knowledge，attitude and practice of humanistic care on nurses in 27 provinces and autonomous regions of China：a multicenter investigation

WU Hongyan, XIE Hongzhen, LIU Yilan, CHEN Yongyi, TIAN Li, GU Zejuan, JIANG Zhixia, WANG Yuqiong, LIU Guiying, ZHANG Hongmei, FAN Ling, LIANG Rong, WANG Xin, LI Xuying, WANG Rong, HUANG Shiming, ZHANG Yulian, HUANG Wen, LUO Mingqin, LIU Xiaomei, FENG Suping, HU Mengyun

2023, 58(19): 2387-2394. DOI: 10.3761/j.issn.0254-1769.2023.19.012

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Objective To learn about current status of knowledge，attitude and practice of humanistic care in Chinese nurses and their influencing factors，so as to provide references to the mangers to accordingly improve their knowledge，attitude and practice. Methods From July to August，2022，a general information questionnaire and a clinical nurse questionnaire of knowledge，attitude and practice were sent out and filled by 15 727 nurses from 107 hospitals in 27 provincial administrative regions of China. Results 15，653 nurses completed the investigation. The total score of knowledge-attitude-practice was 84.19±12.98. The scores of knowledge，belief or attitude，and standard score of practice were 80.22±15.61，83.55±15.17，and 87.92±12.70，respectively. The influencing factors were gender，title，department，satisfaction degree with work，emphasis degree of self-care，received training of humanistic care or not，supporting degree from family to their work，relationship with colleagues，satisfaction degree with salary，and having worked or not in a trial ward of humanistic care（P<0.001）. Conclusion The overall humanistic care of Chinese nurses currently stands at medium level. The knowledge of humanistic care is relatively inadequate. The managers should strength nurse humanistic care training，give organizational support，build a better department atmosphere，and improve nurses’ satisfactions to their work，salaries，and relationship with colleagues，so as to improve nurses’ humanistic care of knowledge，attitude and practice.

Construction and application of a specialized midwife training program based on Shenzhen-Hong Kong cooperation

XIE Qian, ZHANG Xiandan, LIN Jingchun, QIN Lan, DU Jiwei

2023, 58(19): 2395-2400. DOI: 10.3761/j.issn.0254-1769.2023.19.013

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Objective To discuss the development and application of Hong Kong-Shenzhen cooperated standardized specialty midwife training program，and to evaluate the effectiveness. Methods A retrospective study was conducted based on the checking standard of Hong Kong-Shenzhen cooperated standardized specialty training system. 32 trainees who have attended the specialist midwifery training program of our hospital were selected as study subjects from 2021 to 2022，and all trainees received a 2-month long individualized specialty training. After the collection of the satisfaction survey from participants，the program was evaluated from 2 aspects by comparing and analyzing the trainees’s theoretical scores and clinical practice skill scores. Results All participants had a high satisfaction of the training quality of（93.41±5.14）. Scores of theoretical examinations were（77.03±4.60） after training，which were higher than（60.38±4.99） before training，with statistically significant differences（t=13.89，P<0.001）. Scores of clinical practice skill assessment were all above the standard of（87.56±4.23）. All trainees achieved the certificates of completion successfully. Conclusion The development and application of Shenzhen-Hong Kong cooperated standardized specialty midwife training program helped to improve the self-learning ability，training quality and the clinical practice levels of midwives，and promoted the training system of Shenzhen-Hong Kong cooperated specialty midwives.

Nursing care of 3 patients with critical complications after left ventricular assist device implantation

WANG Lin, WENG Fengxia, WEI Jianhua, SANG Ming, GAO Xin

2023, 58(19): 2401-2404. DOI: 10.3761/j.issn.0254-1769.2023.19.014

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To summarize the nursing experience of 3 patients with end-stage heart failure and critical complications after implantation of left ventricular assist device. The main points of care are as follows. A management team was established to formulate the best postoperative management plan，closely monitor circulatory function，and guard against the occurrence of right heart failure. The systematic anticoagulant management was implemented to monitor coagulation function；the continuous ECG monitoring and attention to arrhythmia were conducted；dynamic management of blood sodium level and timely treatment of hypernatremia were carried out； psychological factors were actively adjusted to reduce the risk of delirium. After careful treatment and nursing care，all the 3 cases were transferred to the general ward successfully，and were discharged at 56，29，29 days after surgery，respectively.

Nursing care of 13 patients with spinal cord injury after total thoracoabdominal aortic replacement

LI Yonggang, WU Rong, MA Yan, HUANG Yujia, ZHANG Chen

2023, 58(19): 2405-2408. DOI: 10.3761/j.issn.0254-1769.2023.19.015

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To summarize the nursing experience of 13 patients with spinal cord injury after total thoracoabdominal aortic replacement. The mainly nursing points are as follows：to raise mean arterial pressure and prevent transient hypotension，to prevent the increased spinal cord oxygen consumption caused by abnormal body temperature，to prevent hypoxemia caused by respiratory muscle weakness and lung infection，to intensify cerebrospinal fluid pres-sure monitoring and drainage nursing，to finish fluid balance and renal function monitoring，to prevent the skin pressure injury and wound infection. After careful treatment and nursing care，permanent spinal cord injury occurred in 3 cases and partial or complete recovery occurred in 10 cases at discharge.

A meta-analysis of the effect of web-based psychological intervention in patients with chronic low back pain

LUO Haoyue, LI Qiufang, ZHAO Yanli, LIAN Shali, HAN Shuangrong, YANG Jiayin

2023, 58(19): 2409-2415. DOI: 10.3761/j.issn.0254-1769.2023.19.016

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Objective To evaluate the effect of web-based psychological intervention on the patients with chronic low back pain through meta-analysis. Methods Randomized controlled trials of web-based psychological intervention for patients with chronic low back pain were systematically searched from 9 databases and clinical trial registration platforms including CNKI，CINAHL，Psyclnfo，etc. The search time was limited to January 2023. The literature was screened and extracted by 2 researchers according to the inclusion criteria，and the quality of the literature was assessed using Cochrane Manual 5.1.0. Revman 5.4 software was used for meta-analysis. Results A total of 9 articles，including 1158 patients，were included. Meta-analysis showed that web-based psychological intervention can improve motor fear （SMD=-1.33，95%CI[-1.53 to -1.12]，P<0.001） and pain catastrophe（SMD=-2.16，95%CI[-2.57 to -1.74]，P<0.001），effectively reduce the degree of pain（SMD=-1.35，95%CI[-2.42 to -0.28]，P=0.010），improve self-efficacy（SMD=0.28，95%CI[0.09 to 0.47]，P=0.004），improve disability disorders（MD=-1.66，95%CI[-2.20 to-1.13]，P<0.001），and improve patients’ quality of life（SMD=0.74，95%CI[0.37 to 1.12]，P<0.001） Conclusion Web-based psychological intervention has significant effects on pain catastrophe，motor phobia，self-efficacy and quality of life in patients with chronic low back pain，but it has no significant effect on pain reduction，and further research is needed.

Best evidence summary of decision making in inter-hospital transfer of critically ill patients

LI Shuya, SUN Pengxia, HUA Xiaoxue, GAO Jian, CAI Mengxin, LI Fan

2023, 58(19): 2416-2421. DOI: 10.3761/j.issn.0254-1769.2023.19.017

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Objective To search，evaluate and integrate the best evidence of decision making in inter-hospital transfer of critically ill patients. Methods We searched the evidence about the decision making in inter-hospital transfer of critically ill patients in Guidelines International Network，National Guideline Clearinghouse，Canadian Medical Association CPG Infobase，Scottish Intercollegiate Guidelines Network，National Institute for Health and Care Excellence，Intensive Care Society，Registered Nurses’ Association of Ontario，and Cochrane Library，PubMed，Embase，CINAHL，Web of Science，BMJ，UpToDate、CKNI，Wanfang，and other databases. The retrieval time limit is from the establishment of the databases to June 30，2022. Literature quality assessment and data extraction were performed by 2 researchers. Results A total of 6 articles were included in this study，including 4 guidelines and 2 expert consensuses，which summarized 25 pieces of evidence involving 6 categories，namely necessity assessment，benefit and risk assessment，feasibility related factors，decision-maker，informed consent，medical records. Conclusion This study summarizes the best evidence of decision making in inter-hospital transfer of critically ill patients，and suggests that the inter-hospital transfer system should be standardized，and the outcome，existing problems should be monitored，and normative assessment tools，informed consent and medical record templates should be formed to guide the decision-making.

Research progress of wearable technologies in monitoring and self-management of patients with epilepsy

ZHANG Shanshan, CHANG Hong

2023, 58(19): 2422-2426. DOI: 10.3761/j.issn.0254-1769.2023.19.018

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Epilepsy is a common neurological disease. There are about 10 million epileptic patients in China，proposing a great health-care challenge for the treatment and self-management. The advantages of wearable technologies in the condition of epilepsy are mainly reflected by strengthening management，health warning，improving decision-making，and then reducing management costs and improving efficiency. Therefore，this paper will review the current application of wearable technologies in self-monitoring and management of epilepsy patients，early warning of sudden epileptic death，the improvement of self-management effect and medical compliance，as well as the acceptance of wearable technology among epileptic patients and other stakeholders. This paper will also analyze and discuss potential challenges of its promotion，providing a reference for optimizing the management of epilepsy patients.

Research progress on implementation models of nurse prescribing

TAN Wei, GONG Renrong, LIU Yuwei, CHEN Jiali, JIANG Yan

2023, 58(19): 2427-2433. DOI: 10.3761/j.issn.0254-1769.2023.19.019

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To address the contradiction between the inadequate supply of medical resources and the continuous increase in demand for healthcare services，several countries have granted nurses prescribing authority to broaden the professional scope and expand the role of nurses. This article reviews the research progress on the concepts and implementation models of nurse prescribing，analyzes the challenges of its implementation，and makes the recommendations such as physician-nurse collaborative practice and preferential exploration of specialist nurse prescribing，in order to provide references for exploring the connotation and implementation model of nurse prescribing suitable for national conditions.

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