Table of Content

15 March 2020, Volume 55 Issue 3

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Research Paper

Effects of bundle nutrition intervention on nutritional status and quality of life among elderly patients with gastric cancer undergoing chemotherapy

LIU Xiaoxuan, LI Wei, HUO Xiaopeng, YU Kang

2020, 55(3):  325-330.  DOI: 10.3761/j.issn.0254-1769.2020.03.001

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Objective To explore the effects of bundle nutrition intervention on improving the nutritional status and quality of life among elderly patients with gastric cancer undergoing chemotherapy. Methods A total of 348 elderly patients with gastric cancer who met the inclusion criteria and received informed consent were enrolled and received nutritional risk screening using nutritional risk screening 2002（NRS-2002）. Totally 186 patients with nutritional risk were randomly allocated into the experimental group（94 cases） and the control group（92 cases）. The experimental group received bundle nutritional intervention. The control group received routine nutrition management and dietary guidance. The body weight,body mass index（BMI）,grip strength,lean body mass,body fat,body fat percentage,nutritional intake and quality of life were compared between 2 groups before and after the intervention. Results The prevalence of nutritional risk was 53%. After intervention,the body weight,BMI,grip strength,body fat percentage,lean body mass,75% energy intake and 75% protein intake of the experimental group were higher than those of the control group（P<0.05）. The of physical function,role function,emotional function and overall health of the experimental group were significantly higher than those of the control group（P<0.05）. The scores of fatigue,nausea and vomiting,loss of appetite and insomnia were significantly lower than those of the control group（P<0.05）. Conclusion Bundle nutrition intervention can significantly improve the nutritional status,decrease the prevalence of malnutrition,and improve the quality of life among elderly patients with gastric cancer undergoing chemotherapy.

Investigation on the status of standardized training for new nurses in tertiary general hospitals in China

DING Yanming, WU Xinjuan, LIU Fei, WANG Yi, DENG Jun, CHEN Mei, TIAN Junye

2020, 55(3):  331-336.  DOI: 10.3761/j.issn.0254-1769.2020.03.002

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Objective To investigate the training of newly recruited nurses in tertiary general hospitals,as well as feelings and suggestions of newly recruited nurses in China after the announcement of the Training Outline for Newly Recruited Nurses. Methods From August to September 2018,1 421 tertiary general hospitals and 62 031 newly recruited nurses in China were investigated by convenient sampling. A self-designed questionnaire was used and lauuched through the platform of Wenjuanxing. Results Among the investigated hospitals,91.6% had standardized training programs for newly recruited nurses. The basic training lasted 4.0 weeks（2.0 to 6.0 weeks）,while the professional training lasted 11 months（3.0 to 23.8 months）. The training rate of basic theoretical knowledge ranged from 88.8% to 98.6%,and the training rate of clinical nursing technology ranged from 81.6% to 97.7%. Rotation rates in clinical departments were internal medicine（91%）,surgery（91.8%）,intensive care unit（85.8%）,emergency department（85.1%）,obstetrics and gynecology（72.7%）,operating room（71.3%） and pediatrics（70.6%）. The training methods mainly included demonstration（96.8%）,lecture（95.5%）,nursing rounds（91.5%） and case nursing（82.0%）. Evaluation methods were standardized patients（76.7%） and scenario simulation（63.4%）. Among investigated nurses,78% thought the training content met the Outline;55.8% thought the training duration was appropriate,and 52.0% thought the rotation in clinical departments was appropriate. The recognition rate for training program was 84.2% and newly recruited nurses were most satisfied with the teachers. Group sense of belonging（65.2%）,work intensity（65.0%）,teaching standardization（58.3%）,salary allocation（56.5%）,interpensonal relationship（45.4%）and personal development（45.2%）were factors influencing feelings. Conclusion With the instruction of The training Outline for Newly Recruited Nurses,most of the tertiary general hospitals had implemented standardized training programs. However,length of training,training contents and evaluation methods should be further improved to meet clinical practicing needs. Feelings of nurses should also be emphqsized to promote development of newly recruited nurses.

Special Planning-Coronavirus Disease 2019 Nursing

Holistic care for patients with severe coronavirus disease 2019: an expert consensus

Nursing Department of Tongji Hospital Affiliated to Tongji Medical College Hust, Nursing Department of Peking Union Medical College Hospital, Intensive Care Committee of Chinese Nursing Association

2020, 55(3):  337-342.  DOI: 10.3761/j.issn.0254-1769.2020.03.003

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Objective To standardize the holistic care for patients with severe coronavirus disease 2019（COVID-19）. Methods The consensus was preliminarily formed by combining relevant literature and frontline medical working experience,and it was eventually confirmed by 5 rounds of online discussions and expert consultations. Results This consensus included nursing assessment, nursing priorities, nursing goals,and 13 key points of nursing such as nursing of oxygen therapy and respiratory nursing. Conclusion This scientific and practical consensus guideline can provide clinical guidance on the holistic nursing care of patients with severe COVID-19.

Emergency management of nursing human resources and material resources for coronavirus disease 2019

LIU Yu, WANG Hui, CHEN Junhua, ZHANG Xiaoyun, LE Xiao, KE Jian, WANG Binghua, PENG Chaohua

2020, 55(3):  343-346.  DOI: 10.3761/j.issn.0254-1769.2020.03.004

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The outbreak of coronavirus disease 2019（COVID-19） brought severe challenges to the management of large general hospitals. The Nursing Service Department of our hospital fully executed its functional authority to establish a three-level echelon of sustainable support,allocate the human recourses dynamically,organize pre-service training,supervise the key working steps,formulate positive incentive methods,use and deploy medical supplies scientifically and so on. By taking these strategies,our hospital effectively improved the coping capacity of the nursing team and played a positive role in the prevention and treatment of COVID-19. However,there were still several deficiencies such as insufficient predictive ability and strategic awareness of preparation for emergencies,ineffective reserve system of adequate medical materials,and a lack of specialized emergency nursing teams. The deficiencies indicated that the hospital needs to establish an efficient emergency management system,and pay attention to the practice of nursing emergency plans to enhance coping capacities in public health emergencies.

Emergency management strategies of a nursing service department in the centralized rescue of coronavirus disease 2019

WANG Huafen, FENG Jiehui, SHAO Lewen, WEI Jianhua, WANG Xiaoyan, XU Xiaowei, SHAO Rongya, ZHANG Meiyun, HE Jiangjuan, ZHAO Xuehong, LIANG Tingbo

2020, 55(3):  347-350.  DOI: 10.3761/j.issn.0254-1769.2020.03.005

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This article summarizes a series of emergency management strategies such as early warning activation,continuous advancement,and scientific prevention and control in the centralized treatment of coronavirus disease 2019（COVID-19） from the perspective of nursing service department. The strategies include fully functioning the longitudinal command and horizontal coordination of the nursing service department,reasonable allocating treatment and nursing human resources,and efficiently promoting in-hospital fever clinics,isolation wards,ICU and other centralized treatment and referral and treatment of provincial critical illness patients. 5 prevention and control groups were established for training and examination,management and supervision,psychological assistance,logistical support,and reporting and publicity,so as to ensure the sustainability of prevention and control. With the support of National Clinical Medical Research Center of Infectious Diseases,we optimize the work process,improve the nursing specifications,solve clinical problems,and lead the provincial nursing work. The implementation of these strategies ensures the timely,orderly,safe and efficient centralized treatment. The goal of zero death for severe cases and zero infections for medical staff has been achieved.

Application of refined management in prevention and control of coronavirus disease 2019 epidemic in non-isolated areas of a general hospital

XU Caijuan, JIN Jingfen, SONG Jianping, YANG Yan, YAO Meiqi, ZHANG Yuping, ZHAO Ruiyi, CHEN Zhimei

2020, 55(3):  351-354.  DOI: 10.3761/j.issn.0254-1769.2020.03.006

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Objective This article summarized the experience in the prevention and control of coronavirus disease 2019（COVID-19） epidemic in non-isolated areas in a general hospital,in order to provide references to implement prevention and control methods of nosocomial infection in non-isolated areas for other general hospitals. Methods Based on refined management theory,we professionally developed the standards for prevention and control of COVID-19 in non-isolated areas,systematically implemented various prevention and control measures,performed gridding audit,effectively communicated among teams and between doctors and patients assisted by information techniques,and reported results by data for quality improvement. Results There was no secondary COVID-19 infections among staff in the hospital. The rate of mask wearing,the screening rate of epidemiological history and the rate of medical supplies disinfection were all 100% in the hospital. The accuracy rate of mask wearing of patients and their families was 73.79% and the compliance of their hand hygiene was 40.78%. Conclusion Refined management strategies for the prevention and control of COVID-19 infection in non-isolated areas of the general hospital are effective. The accuracy rate of mask wearing and hand hygiene compliance of patients and their families need to be further improved.

Nursing human resource management in prevention and control of coronavirus disease 2019 in western China

HAN Lin, MA Yuxia, YUE Shuqin, SONG Xiurong, DING Zhaohong, YAN Huiting, SU Qian, SHE Dongli, LIU Jia

2020, 55(3):  355-358.  DOI: 10.3761/j.issn.0254-1769.2020.03.007

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The outbreak of coronavirus disease 2019 brought new challenge to the hospital management. Nursing staff is the cornerstone to fight against the epidemics. It is vital to allocate and manage the nursing staff effectively and reasonably for prevention and control of the infectious disease. This article describes the construction of the management system,the assessment and allocation of nurses,the training and examining and performance management in a tertiary hospital in western China. The purpose of our study is to discuss the ideas and methods of the nursing staff management in the face of sudden epidemics,and to provide references and experience to manage nursing human resource effectively.

Safety management of nasopharyngeal swab specimens from patients with suspected coronavirus disease 2019

QIAN Yan, ZENG Tieying, WANG Hui, XU Min, CHEN Junhua, HU Na, CHEN Daiqi, LIU Yu

2020, 55(3):  359-361.  DOI: 10.3761/j.issn.0254-1769.2020.03.008

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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.

Application effect analysis of infusion process optimization in patients with coronavirus cisease 2019

SONG Yan, WANG Wenhui, ZHANG Lijun, SHA Li, LU Guilan

2020, 55(3):  362-367.  DOI: 10.3761/j.issn.0254-1769.2020.03.009

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Objective To explore the effect of infusion process optimization in patients infected by coronavirus disease 2019. Methods The infusion management team was set up to optimize the infusion process based on the Hamer’s Process Reengineering Theory,and the optimized process was applied to the nursing care of patients with coronavirus disease 2019. The economic indicators,infusion efficiency,nurses’ burnout and patients’ satisfaction were compared before and after optimization. Results After the infusion procedure was optimized,the consumption and disposing costs of personal protective equipment were reduced from 46.67 sets and 186.6 yuan per day to 36.17 sets and 144.6 yuan respectively. The medicine preparation time,dispensing time and average waiting time for patients were reduced from 4.84 minutes,4.03 minutes,and 34.33 minutes to 3.50 minutes,2.60 minutes,and 30.87 minutes respectively. The scores of emotional fatigue and work apathy of nurses decreased from 42.08 points and 11.92 points to 35.08 points and 9.67 points. The satisfaction of patients increased from 66.7% to 93.3%. The differences were statistically significant. Conclusion The optimization of the infusion process can effectively reduce the consumption of protective materials,save medical resources,improve the efficiency of nurse infusion,reduce the job burnout of nurses,and improve patients’ satisfaction.

Investigation on the current situation of purification air conditioning system in operating rooms during epidemic of coronavirus disease 2019

HE Jiqun, CHEN Xiuwen, XIAO Yingping, PENG Luofang, YAN Xiaochen, CHENG Pengfei

2020, 55(3):  368-372.  DOI: 10.3761/j.issn.0254-1769.2020.03.010

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Objective To investigate the setting and management status of purification air conditioning system in operating rooms of hospitals in Hunan Province,so as to provide a basis for effective guidance in the prevention of coronavirus disease 2019 infection during surgeries. Methods 162 head nurses were selected from 162 hospitals in Hunan Province by convenient sampling method,using a questionnaire survey. The self-designed questionnaire included the general information of study subjects and the current situation of setting and management of purification air conditioning system in operating rooms. Results Among the 158 enrolled hospitals,62（39.24%） had professional engineers responsible for maintaining and managing the purification air conditioning system;125（79.11%） had clean operating rooms;75（47.47%） had negative-pressure operating rooms. There were statistically significant differences in the settings of professional engineers,clean operating rooms and negative-pressure operating rooms among different hospital levels（P<0.05）. Among the 75 hospitals with negative-pressure operating rooms,13（17.33%） and 31（41.33%） hospitals did not have independent purification air conditioning systems and channels;the air return port in 17（22.67%） hospitals and the air outlet filters in 20（26.67%） hospitals were high-efficient filters. 41（54.27%） hospitals did not develop the management process of negative-pressure operating room. Conclusion Purification air conditioning system on operating room is crucial to prevent and control hospital cross infection. Nursing managers should understand the setting and parameter requirements of purification air conditioning system,and strengthen training of the negative-pressure operating room. Hospitals need to develop prevention and control strategies of coronavirus disease 2019 infection in operating rooms,and improve the quality of management to ensure the operation safety.

Special Planning-Nursing Informationalization

Establishment and practice of a hospital information system of prevention and treatment for venous thromboembolism

YU Hongmei, PAN Hongying, ZHAN Yufen, HUANG Chen, CHENG Lili, LI Diqiong, DING Shanni, WU Mizhi

2020, 55(3):  373-378.  DOI: 10.3761/j.issn.0254-1769.2020.03.011

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Objective To establish a prevention and treatment system of venous thromboembolism（VTE） based on hospital informationization,and to improve the cognition and the management of VTE. Methods A team of VTE prevention and treatment management was established;the working process of informationized VTE prevention and treatment was built;key management measures were taken such as mandatory pre-operation risk assessment,intelligent early warning system of rapid response intellegent,nursing decision-making system and structural follow-up. The system was officially in application from September to December,2018,which was used to compare the data from September to December,2017,comparing VTE risk assessment rate,bleeding assessment rate,implementation rate of VTE related measures,incidence of deep vein thrombosis（DVT） and pulmonary thromboembolism（PTE）,and VTE related mortality. Results After the application,VTE risk assessment rate was increased from 0.5% to 75.5%,and bleeding assessment rate was increased from 1.4% to 75.8%. The implementation rate of VTE related measures reached 100% for basic prevention,15.7% for moderate/high-risk patients and 25.9% for drug prevention. The incidence of PTE in the hospital was increased from 2.8‰ to 4.35‰;the incidence of DVT was increased from 2.8‰ to 6.28‰; the VTE-related mortality was decreased from 14.03‰ to 1.78‰,and the differences were statistically significant（P<0.05）. Conclusion The establishment and practice of the hospital information system of venous thromboembolism prevention and treatment can improve the cognition of medical staff towards prevention and treatment of VTE,improve implementation of clinical VTE prevention and treatment,and decrease VTE-related mortality.

Establishment and application of PICC information management platform for intravenous treatment league

XIAO Shuang, ZHAO Qinghua, XIAO Mingzhao, LIU Guangwei, HE Qin, TANG Wenfeng, LIU Yue, HU Lei, LU Ye, WANG Qi

2020, 55(3):  379-382.  DOI: 10.3761/j.issn.0254-1769.2020.03.012

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Objective To establish and apply the PICC information management platform for intravenous treatment league to achieve PICC continuity care. Methods We designed the functions of PICC information platform in accordance with the requirements of “Internet + Nursing Services”. We designed a simplified model of the PICC information platform based on the Freeman 2007. We established and applied the PICC information management platform for Chongqing intravenous treatment league,and evaluated the effects. Results The PICC information platform consisted of management center （PC） and mobile phone client end（APP）for nurses and patients. The nurses end contained 13 modules in 4 sections,and the patients end contained 10 modules in 5 sections. The platform was able to collect the whole-process data of PICC insertion,maintenance,and extubation,as well as management data such as consulting,consultation,and follow-up generated during the process,realizing continuity of PICC care process. Untill May 31 ^st,2019,the platform has been used for 2.5 months,with 81 registered hospitals,1595 registered medical staff,and 457 patients. The amount of data reported by tertiary hospitals in the platform was significantly higher than that by other hospitals. Conclusion The PICC information management platform provides closed-loop management of PICC continuity care,enhances the initiative of PICC patients’ self-management,and supports the exploration of “online + offline” specialist care models.

Construction and application of an informationized platform of blood collection

ZHU Li, SHI Donglei, WANG Jun, WU Fan

2020, 55(3):  383-386.  DOI: 10.3761/j.issn.0254-1769.2020.03.013

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Objective To optimize blood collection process for reducing waiting time of patients and avoiding large number of patients gathered in the area of blood collection. Methods An informationized blood collection registration platform was established consisting of blood-collecting registration module,intelligent distribution module and information backup storage module. Patients completed blood collection registration or appointment through self-service machine in hospital and APP in mobile phones to operate on the platform. The platform realized the intelligent allocation of blood collection patients from time and space. Time spent on the registration and waiting for blood collection before and after application of the platform was compared. Results After the application of the platform in 2018,the rate of reducing time on blood collection registration was 77.50% compared with that in 2017,and the difference was statistically significant（P<0.001）. The rate of reducing time on waiting for blood collection was 47.91%,and the difference was statistically significant（P<0.05）. Conclusion The application of the informationized blood collection registration platform optimized the process of blood collection,which can effectively reduce patients’ waiting time,and assign patients at different time intervals to avoid large numbers of people gathering. It was helpful to optimize the order of blood collection in the hospital,and reduce the occurrence of adverse events.

Effect assessment of an information platform for standardized nursing management of cancer pain

DING Qunfang, HUANG Jing, JIANG Zifang, WU Wanying

2020, 55(3):  387-390.  DOI: 10.3761/j.issn.0254-1769.2020.03.014

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Obiective To construct the information platform for standardized nursing management of cancer pain and to assess its effects. Methods The information platform of standardized nursing management of cancer pain was used for homogeneous management. The indicators of quality control in standardized nursing management of cancer pain from 2016 to 2018 were compared by the cluster research method. Results After the information platform for standardized nursing management of cancer pain was put into use,100% of patients were screened for cancer pain;the rate of timely follow-up of patients with cancer pain increased from 30.28% to 96.44%;the rate of the follow-up completion increased from 54.78% to 99.84%. The timely treatment rate of outbreak pain increased from 85.21% to 96.54%. The correct record rate of nursing pain increased from 86.23% to 95.21%;the score of nursing quality control increased from 88.32 to 96.89;the satisfaction of pain control increased from 85.82 to 94.96;the difference of each index had statistical significance（P<0.01）. Conclusion The information platform for standardized nursing management of cancer pain played an important role in the establishment of the standardized treatment model of cancer pain in hospitals, and the successful exprience is worth being spread.

Analysis and prospect of applicating Clinical Care Classification System in nursing practice of intensive care unit

JI Xiaobo, CAO Chuan, YANG Lei, CONG Peilong

2020, 55(3):  391-396.  DOI: 10.3761/j.issn.0254-1769.2020.03.015

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Objective To explore the application of clinical care classification（CCC） intelligent nursing information systems in the practice of intensive care nursing. Methods The CCC intelligent nursing information system was used to analyze the nursing care records during the study. The study data included all nursing records from March 2019 to July 2019,for a total of 301,358 care document entries. Results The data collected from the CCC intelligent nursing information system showed that among the nursing diagnosis of patients,physiological factors accounted for 45.14%,functional factors accounted for 41.62%,health behavior factors accounted for 12.33%,and psychological factors accounted for 0.91%. Skin care in the classification involved the largest part of caring（24.67%）,followed by activity（21.55%）,safety（15.09%）,and body conditioning（13.72%）,of which the monitoring and monitoring measures accounted for the total care. More than half of the measures（52.39%）,nursing implementation measures accounted for 26.56%,while teaching guidance and management referrals accounted for 11.68% and 9.36%,respectively;there was a statistically significant difference between the actual nursing outcomes and the expected goals of care. Conclusion The CCC can be used to document nursing data and writing nursing care electronic records for individualized clinical Nursing practices in patients in intensive care unit. It can also be used analyze the frequency and frequency of each care content. Conducive to the establishment and analysis of nursing big data;the application of Clinical Care Classification system can promote the clinical nursing practice and nursing research in Intensive Care Unit.

Specialist Practice and Research

Construction of nutritional nursing quality evaluation index system for patients with inflammatory bowel disease based on the three-dimensional quality structure

WANG Qingwen, ZHU Aifang, GUO Bingmei, XU Na, LI Xiaohui, ZHANG Mei, LI Xiaoxia

2020, 55(3):  410-415.  DOI: 10.3761/j.issn.0254-1769.2020.03.019

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Objective To build the nutritional nursing quality evaluation index system of inflammatory bowel disease （IBD） and provide references for clinical standardized nutritional nursing intervention. Methods Literature retrieval as the theoretical basis was conducted based on the three-dimensional quality structure model and clinical practice for sensitive quality indicators system of nutrition nursing. Expert meetings were conducted to establish a first draft of IBD nutritional nursing quality evaluation indexes,which primarily included 3 primary indexes,8 secondary indexes and 71 tertiary indexes. A total of 35 IBD experts from 8 provinces and cities of Beijing,Hubei,Hunan,Shanxi,Guangdong,Shaanxi,Jiangsu,and Shandong were selected. After 2 rounds of Delphi method-based expert consultations,the evaluation index system of nutritional nursing quality for IBD patients was finally established. Results Positive coefficients of the 2 rounds of expert consultation were both 100%. The authoritative coefficient was 0.81,and the coordination coefficients were 0.131 and 0.142,respectively. At last,the nutritional nursing quality evaluation index system for IBD patients was constructed including 3 primary indexes,8 secondary indexes and 59 tertiary indexes. Conclusion This study on nursing-sensitive quality indicators system was scientific and reliable,and it would be beneficial to evaluate the nutritional nursing quality for IBD patients.

Risk factors and predictive analysis of acute severe abdominal pain after transarterial chemoembolization

BIAN Lifang, GAO Beilei, ZHANG Sheng, ZHAN Dongdi, GE Guomei, YE Tingting, ZHENG Yan

2020, 55(3):  416-421.  DOI: 10.3761/j.issn.0254-1769.2020.03.020

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Objective To observe and investigate the occurrence regularity and risk factors of acute moderate and severe abdominal pain after transarterial chemoembolization（TACE）,and to establish a prediction model of postoperative pain after TACE. Methods Retrospective cohort study was used to collect patients with primary liver cancer treated by TACE from January to June 2018 in a hospital. The patients were divided into abdominal pain group and non-pain group. The data of 2 groups was analyzed by univariate analysis. The statistically significant factors were analyzed by multivariate Logistic regression analysis,and the pain prediction model was established. The model evaluation and internal verification were carried out. Results A total of 367 patients were enrolled in this study and 425 times of TACE were performed in half a year. The statistical results showed that no moderate and severe abdominal pain occurred after preventive TACE. Multiple liver tumors（the number of tumors≥3）,a history of pain after TACE,transarterial chemoembolization with drug-eluting beads and a low number of TACE were independent predictors of acute moderate and severe abdominal pain. The area under the predicted ROC curve was 0.794（95%CI0.736~0.852）,and the test result of Hosmer-Lemeshow showed that χ ²=2.205,P=0.974. Conclusion The prediction model constructed in this study can predict acute moderate and severe abdominal pain after TACE,and can provide references for medical staff with management measures of preventive pain.

Study on the real caring experience of intensive care unit nurses on patients with long-term coma

CHEN Jiali, ZENG Li

2020, 55(3):  422-426.  DOI: 10.3761/j.issn.0254-1769.2020.03.021

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Objective To explore the real caring experience of nurses in neurological intensive care unit on long-term coma patients. Methods In the perspective of phenomenological approach,a total of 11 neurological intensive care unit nurses were enrolled for the semi-structured in-depth interviews and Colaizzi method was used to analyze the data. Results 5 themes were extracted,including forming multiple emotional experience（love and hurt coexisted with empathy;disappointment mingled with hope）,understanding the necessity of professionalism（practicing carefully and improving the quality of nursing;regarding patients as the center and reflecting the humanistic nature of nursing）,perceiving the importance of critical thinking（critical thinking is the key to apply professional knowledge;pre-judgement condition prediction provides effective guarantee for successful rescue）,gaining a sense of self-identity,reviewing the relationship between ethics and clinical decision making（persisting because of kinship and family tie,giving up because of the poor quality of life）. Conclusion The caring experience of neurological intensive care unit nurses on patients with long-term coma is multidimensional. Meanwhile,it is pointed out that the nursing supervisors should foster nurses’ professionalism,strengthen nurses’ professional mindset,increase nurses’ self-worth and enhance the ability of clinical decision-making based on the consideration of life and ethics,which could provide better care for the neurological patients with long-term coma.

Investigation on the management status of sexual problems of postoperative patients with cervical cancer by gynecological medical staff in Chongqing

SHI Yan, GAN Xiuni

2020, 55(3):  427-432.  DOI: 10.3761/j.issn.0254-1769.2020.03.022

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Objective This study aimed at understanding the status of cognition,behavior,responsibility and barriers of gynecological medical staff towards management of sexual problems of postoperative patients with cervical cancer in Chongqing,in order to provide references for formulating sexual health guidance of postoperative patients. Methods A total of 191 gynecological medical staff members from 19 hospitals in Chongqing were surveyed by the self-designed questionnaire from February to April 2019. Results The cognition score of medical staff was 13~44（29.62±7.21）;the behavior score was 7~25（12.87±3.47）. 91.6% of participants thought that they should provide sexual counseling or diagnosis and treatment services for patients and 83.8% thought gynecologists were the primary person responsible for managing sexual problems. The most frequently mentioned management barriers were low literacy of patients（88%）,lack of professional training for medical staff（79.6%）,lack of sexual therapists or referral departments（81.7%） and lack of systematic treatment programmes（84.3%）. Multivariate linear regression analysis showed that professional title,training,cognition of sexual problems management,responsibility of sexual problems management and management barriers were influencing factors of managing sexual problems of medical staff（P< 0.05）. Conclusion The gynecological medical staff paid insufficient attention to the sexual problems of postoperative patients and there was no systematic management plan. It is necessary to improve the awareness of medical staff and to provide relevant training.

Nursing Education

The preliminary construction of the training course for nursing simulation facilitators

LING Tao, JIN Ruihua, HUAI Panpan

2020, 55(3):  433-439.  DOI: 10.3761/j.issn.0254-1769.2020.03.023

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Objective To construct a training course for nursing simulations facilitators,so as to promote the theoretical and practical research on nursing simulation-based education. Methods The training course and weight of each indicator were established by literature review,surveys of current status,Delphi consultation and Analytic Hierarchy Process. Results After 2 rounds of expert consultation,questionnaire response rates were 88.46% and 100%. Experts’ authority coefficient was 0.881,Kendall coordination coefficients were 0.203 and 0.244,and P values were all less than 0.01. The final course consisted of 5 dimensions,24 first-level indicators,95 second-level indicators. Conclusion The results of the study are reliable and the course can provide references for development of simulation-based teaching ability of nursing teachers and simulation-based nursing education.

The establishment of a core competence indicator system for baccalaureate midwifery graduates

LI Xinxin, TAO Yuanling, WU Xia, ZHOU Sijia, ZHANG Lili

2020, 55(3):  440-444.  DOI: 10.3761/j.issn.0254-1769.2020.03.024

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Objective To construct a core competence indicator system for baccalaureate student midwives in China and to guide competency-based midwifery education. Methods Literature review,open-ended questionnaires and Behavioral Event Interview（BEI） with 21 clinical midwives were undertaken,followed by 2 rounds of Delphi technique with experts evaluation to identify the weight of each indicator. Results The response rates of 2 rounds were both 100%. The authority coefficients of experts in 2 rounds were 0.905 and 0.950 respectively,with coordination coefficients of 0.254 and 0.228 respectively（P<0.001）. The indicator system consisted of 4 dimensions including professional knowledge,skills,attitudes and behaviors,along with 30 competencies. Conclusion The core competence indicator system is scientific and reliable,which can provide a reference for revolution of competency-based higher education of midwifery in China.

Evidence Synthesis Research

A meta-analysis of risk factors for acquired swallowing disorders among patients after cardiac surgery

YU Jintian, CHEN Junshan, ZHANG Aiqin

2020, 55(3):  451-455.  DOI: 10.3761/j.issn.0254-1769.2020.03.027

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Objective To identify the risk factors of acquired swallowing disorders among patients after cardiac surgery by meta-analysis. Methods Electronic databases and references of included studies were searched. 2 reviewers independently screened literature according to the inclusion and exclusion criteria,extracted data,and assessed the quality of included studies. Meta-analysis was conducted by Rev Man 5.3. Results 12 studies were recruited,including 6,527 cases. 22 risk factors of acquired swallowing disorders among patients after cardiac surgery were involved,among which age,chronic lung diseases,chronic kidney diseases,cerebrovascular diseases,congestive heart failure,NYHA functional classification,peri-operative stroke,cardiopulmonary bypass time,aortic block time,endotracheal intubation time and indwelling gastric tube time were independent predictors of acquired swallowing disorders. Conclusion Due to insufficient evidence on the risk factors of acquired swallowing disorders among patients after cardiac surgery and inconsistent evaluation methods of swallowing disorders,more strictly designed studies are needed to further identify the risk factors of acquired swallowing disorders among patients after cardiac surgery.

Best evidence summary for management of output and input in chronic heart failure patients

ZHAO Xu, WANG Wei, ZHAO Xiaojing, LI Guangzhao, JIN Lin, YANG Lijuan

2020, 55(3):  456-461.  DOI: 10.3761/j.issn.0254-1769.2020.03.028

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Objective To search and summarize the best available evidence on management of output and input in chronic heart failure patients. Methods We searched the BMJ Best Practice,UpToDate,Joanna Briggs Institute,Guideline International Network（GIN）,National Guideline Clearinghouse（NGC）,National Institute for Health and Care Excellence（NICE）,Registered Nurses Association of Ontario（RNAO）,Scottish Intercollegiate Guidelines Network（SIGN）,Chinese Guideline Network,Cochrane Library,PubMed,Embase,CINAHL,CBM,World Health Organization（WHO） and various professional association websites,etc.,to collect evidence including guideline,best practice information sheet,evidence summary,recommended practice,and systematic review on management of output and input in chronic heart failure patients. 2 authors independently assessed quality and extracted data. Results Totally 8 articles were enrolled,including 1 clinical decision,5 guidelines,2 systematic reviews,and 1 expert consensus. Finally 13 pieces of best evidence were summarized including the multidisciplinary cooperation team,assessment and monitoring,sodium and fluid restriction,usage and regulation of diuretic,aerobic exercise and patient education. Conclusion Our research summed the best evidence on management of output and input in chronic heart failure patients. Nursing managers should establish a scientific management system for output and input,provide regular training for members,and develop programs of individualized body fluid management for patients.

Overseas Knowledge

Translation of the multimorbidity treatment burden questionnaire and assessment of its reliability and validity among the elderly

DOU Liyuan, HUANG Juan

2020, 55(3):  476-480.  DOI: 10.3761/j.issn.0254-1769.2020.03.032

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Objective To translate the multimorbidity treatment burden questionnaire （MTBQ） and assess its reliability and validity among the elderly patients with multimorbidity. Methods The Brislin model was used to translate,synthesize,back-translate and cross-culturally adapt the MTBQ. 220 patients from 4 communities under the jurisdiction of a community health service center in Zhengzhou were selected by convenient sampling method,and the patients were investigated to evaluate the reliability and validity of the questionnaire. Results The Chinese version of the MTBQ had validity index of horizontal content 0.97,and the validity index was item level content was 0.83~1.00. 3 common factors were obtained,and the cumulative variance contribution rate was 54.351%. The total Cronbach’s α coefficient of the questionnaire was 0.808,and the test-retest reliability was 0.743. The Cronbach’s α coefficients of the 3 common factors were 0.796,0.653 and 0.611;the test-retest reliability were 0.827,0.806 and 0.713. Conclusion The Chinese version of the MTBQ questionnaire has good reliability and validity in elderly patients with multimorbidity,and can be used to evaluate the multimorbidity elderly treatment burden of patients in China.