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The levels of psychological resilience and influencing factors path analysis in ICU patients with physical restrain CHEN Qiaoling, LIN Ruyu, ZHU Xuanjing, BIE Yuanyuan, ZHAO Huiling Chinese Journal of Emergency and Critical Care Nursing    2024, 5 (1): 10-15.   DOI: 10.3761/j.issn.2096-7446.2024.01.001 Abstract （148）            Knowledge map    Objective To describe the level of psychological resilience in ICU physically restrained patients and to explore the influencing factors. Methods A general information questionnaire，Connor-Davidson Resilience Scale， Social Support Rating Scale，General Self-Efficacy Scale，Medical Coping Modes Questionnaire，and the Chinese short version of the Eysenck Personality Questionnaire were used to investigate 301 physically restrained patients admit- ted to the Department of Intensive Care Medicine of a tertiary class A hospital in Fujian Province from December 2021 to December 2022. Structural equation modelling was used to conduct the path analyses for the various influ- encing factors. Results Total psychological resilience score of ICU physically restrained patients was （53.17 ± 17.41），self-efficacy score was （25.16±7.96），social support score was （38.93±15.12），medical coping total score was （44.15±15.21），and Eysenck's personality total score was （23.68±2.98）. The total psychological resilience score of ICU physically restrained patients was positively correlated with the total social support score （r=0.585，P<0.001）， positively correlated with the total self-efficacy score （r=0.545，P<0.01），positively correlated with the confrontation dimension of the medical coping styles （r=0.602，P<0.01），and negatively correlated with the yielding and avoidance dimensions （r=-0.567，P<0.01；r=-0.627，P<0.01），positively correlated with the introversion and extroversion dimen- sions of personality traits（r=0.326，P<0.01），and negatively correlated with neuroticism，psychoticism，and dissimulation scores （r=-0.395，P<0.01；r=-0.338，P<0.01；r=-0.362，P<0.01）. The model was well-fitted，social support had direct and indirect effects on psychological resilience（r=0.546，P<0.001；r=0.267，P<0.001），self-efficacy had a direct effect onpsychological resilience （ r=0.218，P<0.001）. Confrontation coping style had a direct positive effect on psychological resilience（ r=0.415，P<0.001），avoidance coping style had a direct negative effect（ r=-0.216，P=0.007） and resignation coping style had a direct negative effect on psychological resilience （ r=-0.431，P<0.001）. Personality traits had a significant negative effect on psychological resilience（r=-0.606，P<0.001）。 Conclusion The overall level of psychologi- cal resilience of ICU physical restraint patients is low. Social support，self-efficacy，coping styles，and personality traits are important influencing factors on the psychological resilience of ICU physical restraint patients. Improving the level of their psychological resilience can be approached from these four factors. Related Articles | Metrics

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Summary of the best evidence for vasoactive drug infusion in adult patients WANG Fang, ZHANG Shuzeng, NIE Anliu, SU Xiangfen Chinese Journal of Emergency and Critical Care Nursing    2024, 5 (3): 275-282.   DOI: 10.3761/j.issn.2096-7446.2024.03.016 Abstract （117）            Knowledge map    Objective To summarize the best evidence for safe infusion of vasoactive drugs in adult patients，and to provide evidence support for clinical nursing work. Methods We searched UpToDate，BMJ Best Practice，Joanna Briggs Institute library，Cochrane Library，National Guideline Clearinghouse，Centers for Disease Control and Preven- tion，National Institute for Health and Care Excellence，Guideline International Network，CINAHL，Embase，Registered Nurses’ Association of Ontario，UK Intensive Care Society，American Intravenous Nurses Society，PubMed，Web of Science，CNKI，Wanfang Database，VIP，Chinese Nursing Association，SinoMed，Yimaitong to collect guidelines，expert consensuses，group standards，systematic reviews，evidence summaries and original study on vasoactive drug infusionin adult patients. The retrial limit was from January 1，2013 to March 10，2023.Literature quality evaluation and ev- idence screening were conducted independently by two researchers with evidence-based nursing research back- ground，and the evidence was classified and integrated by the team after summary. Results A total of 12 litera- tures were included，and 29 pieces of evidence were summarized from five dimensions：training and education，evalu- ation，vascular access selection，infusion scheme and complications management. Conclusion This study summarizes the best evidence of vasoactive drug infusion in adult patients，which can provide medical staff with scientific infu- sion regimen，ensure patient safety and improve the quality of care. Related Articles | Metrics

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Study on the application effect of different sealing solutions in the totally implantable venous access portamong tumor patients ZHU Wei, QIN Xiaoying, HUANG Peipei, XIANG Xiaoyan, LU Qi, CHEN Lijiao, CUI Zhiping, ZHANG Ye Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (7): 581-586.   DOI: 10.3761/j.issn.2096-7446.2023.07.001 Abstract （251）            Knowledge map    Objective To compare the application effects of different sealing solutions in totally implantable venous access port among tumor patients. Methods A randomized sampling was used to select 414 patients who were maintained infusion port in outpatient department of a tertiary Grade A hospital in Zhejiang Province from December 2018 to December 2022. They were divided into three groups，A，B，and C，with 138 cases in each group，using a random number table method. Patients were treated with 5 ml 0.9% sodium chloride for positive pressure sealing during intermittent maintenance in group A，and 5 ml heparin（10 U/ml） for positive pressure sealing in group B，and 5ml heparin（100 U/ml） positive pressure sealing in group C. To observe coagulation function and catheter blockage in patients among three groups. Results There were statistically significant differences in prothrombin time and activated partial thrombin time among the three groups（P<0.05）. There was no significant difference in D-dimer quantity and platelet count（P>0.05）. The pair comparison of prothrombin time among the three groups showed that there was no statistical significance between group A and group B（t=-34.409，P>0.05），but there were statistically significant differences between group A and group C（t=-179.308，P<0.001） and between group B and group C（t=-144.899，P<0.001）. The pairwise comparison of activated partial thromboplastin time among the three groups showed that there was no statistical significance between group A and group B（t=1.406，P>0.05）， but there were statistically significant differences between group A and group C（t=-35.493，P<0.05） and between group B and group C（t=-36.899，P<0.05）. Conclusion Among cancer patients with totally implantable access port during intermittent maintenance period，the use of heparin solution（100 U/ml） can prolong prothrombin time andactivated partial thromboplastin time. It is recommended that clinical nursing staff seal the tube with 0.9% sodium chloride or heparin solution（10 U/ml） in outpatient patients undergoing intermittent maintenance. Related Articles | Metrics

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Latent profile analysis and factors influencing early post-traumatic growth in young and middle-aged accidental trauma patients SU Xin, GAO Yufang, LIU Dun Chinese Journal of Emergency and Critical Care Nursing    2024, 5 (2): 115-120.   DOI: 10.3761/j.issn.2096-7446.2024.02.003 Abstract （74）            Knowledge map    Objective Based on potential profile analysis，to understand the category characteristics of post- traumatic growth level of young and middle-aged accidental trauma patients，and to explore the influencing factors of different categories of post-traumatic growth level in accidental trauma patients. Methods Through a cross- sectional study，225 young and middle-aged accidental trauma patients in the Department of Trauma Surgery of a tertiary hospital in Qingdao City from October 2022 to March 2023 were selected by convenience sampling method. A general information questionnaire and the simplified Chinese version of the Posttraumatic Growth Rating Scale were used for survey. Results The results of potential profile analysis showed that the posttraumatic growth characteristics of young and middle-aged accidental trauma patients could be categorized into four potential categories：low-growth group （1.8%），medium-growth group （62.3%），medium-growth-high-relationship group （32.6%）， and high-growth group （3.4%）. The results of the multiple logistic regression analysis showed that age，per capitamonthly family income，payment method，and type of trauma were the influencing factors of posttraumatic growth in young and middle-aged accidental trauma patients （P<0.05）. Conclusion There is obvious heterogeneity in the level of post-traumatic growth of young and middle-aged accidental trauma patients，and it is recommended that healthcare professionals carry out interventions such as psychological counseling and appropriate information support according to the characteristics of different post-traumatic growth categories in patients in order to improve the level of post-traumatic growth of patients. Related Articles | Metrics

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Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (6): 573-.   Abstract （103）            Knowledge map    Related Articles | Metrics

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Interpretation of group standards for skin care of adult incontinence GAO Yanhong, ZHAO Nuo, LIU Chunmei, WANG Ling, ZHOU Yujie, WANG Xia, GUO Tong, WEI Li, ZHANG Su, WANG Zhiwen, ZHANG Zhixia, HUANG Zheng, JI Huiru, GUO Shuli, JIANG Qixia, XU Honglian, HU Hongyang, ZHANG Hongmei, HU Ailing, SUN Hongling, FU Xiaojin, WU Xinjuan Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (7): 620-624.   DOI: 10.3761/j.issn.2096-7446.2023.07.010 Abstract （596）            Knowledge map    The unified and standardized skin care norms and procedures for incontinence patients provide clinical standard guidance for nursing staff，and are also the guiding basis for reducing the incidence of skin complications of patients. In 2022，the Third Medical Center of the General Hospital of the People’s Liberation Army collaborated with 16 hospitals nationwide to write the group standard of the Chinese Research Hospital Association “skin care norms for adult incontinence patient （T/CRHA 016-2023）”，which was released in January 2023. It mainly standardized the overall evaluation of skin care for adult incontinence patients，the selection of nursing products，the standard process and the key points of nursing. This article explained the important parts and items in this standard in detail to facilitate users’ understanding and promote the standardized practice of skin care for patients with clinical incontinence. Related Articles | Metrics

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Development and psychometric testing of a questionnaire measuring knowledge，belief and practice of prone position ventilation for patients with ARDS among ICU medical staf LI Yajun, WU Qiang, ZHANG Jing, CHEN Lianfang, LI Xiuchuan Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (7): 587-593.   DOI: 10.3761/j.issn.2096-7446.2023.07.002 Abstract （206）            Knowledge map    Objective To develop a questionnaire measuring the knowledge，belief，and practice of prone position ventilation for patients with ARDS among ICU medical staff，and to conduct reliability and validity testing. Methods Based on the knowledge，belief，and behavior theory model，an initial questionnaire was formed through literature study，theoretical analysis，expert interviews，Delphi expert consultation，and preliminary surveys. From October to November 2022，426 ICU medical staff from 7 tertiary comprehensive hospitals in Anhui Province were selected as the research subjects for reliability and validity testing. From January to February 2023，another 455 ICU medical staff from 7 tertiary comprehensive hospitals were selected as the survey subjects for confirmatory factor analysis. Results The final questionnaire consisted of three dimensions：knowledge，belief，and behavior，with a total of 41 items. The cumulative variance contribution rate of the three factors in exploratory factor analysis was 65.319%，and all fitting indicators in confirmatory factor analysis were within an acceptable range （χ2/df=2.504，RMSEA=0.058， RMR =0.014，IFI =0.933，CFI =0.933，PGFI =0.740，PNFI =0.846，PCFI =0.883）. Questionnaire Cronbach’s α coefficient was 0.982，the retest reliability was 0.995，and the split half reliability was 0.950. Conclusion This questionnaire has good reliability and validity，and is suitable for investigating the current status of ICU medical staff’s knowledge，belief，and practice of prone ventilation in ARDS patients. Related Articles | Metrics

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The effect of prehospital process optimization on treatment delay in patients with ischemic stroke：a Meta- analysis GUO Zhiting, JIN Jingfen, LIU Yuanfei, FU Yujia, WANG Xuyang, GUO Erling, ZHANG Yuping Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (7): 644-652.   DOI: 10.3761/j.issn.2096-7446.2023.07.016 Abstract （65）            Knowledge map    Objective To investigate the effect of prehospital procedure optimization on treatment delay and clinical outcome of ischemic stroke. Methods We searched PubMed，Embase，Cochrane Library，Web of Science， China Biomedical Literature Database，Wanfang data knowledge service platform，China National Knowledge Infrastructure，VIP database to collect intervention studies or cohort studies related to pre-hospital workflow optimization. The search period was from the database establishment to November 2022. Two evidence-based trained researchers independently screened literature，extracted data，and evaluated quality according to inclusion and exclusion criteria. Meta-analysis was performed using RevMan 5.3 software. Results Twenty-four literatures with a total of 197 154 patients were included. The results showed that prehospital procedure optimization could improve the rate of reperfusion therapy in patients with ischemic stroke[OR=1.98，95%CI（1.57，2.49），Z=5.75，P<0.001］ and shorten the time from symptom onset to thrombolytic therapy[WMD=-21.64，95%CI（-33.32，-9.97），Z=3.63，P<0.001］， the time from ambulance call to thrombolytic therapy[WMD=-30.29，95%CI（-44.14，-16.45），Z=4.29，P<0.001］ and the time of intra-hospital thrombolytic therapy or intravascular therapy to improve the clinical outcome of patients [OR=1.99，95%CI（1.29，3.05），Z=3.12，P=0.002］，but had no significant effect on the improvement of entry time from symptom onset to emergency room[WMD=-6.88，95%CI（-16.62，2.86），Z=1.38，P=0.17］. Conclusion Prehospital procedure optimization can effectively improve the reperfusion treatment rate and prognosis of patients with ischemic stroke，but the improvement of prehospital time is small，suggesting that the prehospital process needs to be further optim Related Articles | Metrics

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A field study of the status and contents of nursing practice in the management of blood glucose in critically ill adults HUANG Miao, GAN Xiuni, ZHANG Chuanlai, ZHOU Wen Chinese Journal of Emergency and Critical Care Nursing    2024, 5 (2): 101-107.   DOI: 10.3761/j.issn.2096-7446.2024.02.001 Abstract （272）            Knowledge map    Objective To understand the status and contents of current nursing practice in the management of blood glucose in critically ill adult patients in China. Methods From September 2021 to April 2022，an 8-month non-participatory observation of glucose management practice in the intensive care units of four tertiary care hospitals in Chongqing was conducted using field research. Quantitative data were collected using the ICU patient glucose management profile form and nursing staff glucose management practice record form. We repeatedly read the field notes and summarized existing nursing practices and existing problems in current blood glucose management nursing practices，further categorized and conducted in-depth analysis of the data. Results All four field observation sites had paper-based insulin infusion protocols，and the mean duration of the use of the protocols was（9±2.92） years，and the contents of the protocols differed across the fields. A total of 60 hyperglycemic patients were observed，and there were no statistically significant differences in the duration of hyperglycemia，the time required to reach target blood glucose level，and the maintenance of the target blood glucose range among patients from different field sites. The main tasks of the 12 nurses in glucose management included insulin infusion and adjustment，glucose monitoring，patient nutrition management，and hypoglycemia treatment. However，there was still a gap with the best evidence on blood glucose monitoring method，insulin use，whether nutritional support should be combined with insulin infusion，etc. Conclusion Nursing staff need to enhance their clinical decision-making skills，and further construct and implement a comprehensive and standardized practice plan for glucose management in critically ill adult patients based on the best evidence. This is a main solution to address current glucose management practice issues in the field sites. Related Articles | Metrics

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Risk factors of hypothermia in emergency trauma patients：a meta-analysis JING Chenyang, GUO Yue, FAN Luo, JI Li, WANG Tuohong, HE Guobao Chinese Journal of Emergency and Critical Care Nursing    2024, 5 (2): 131-137.   DOI: 10.3761/j.issn.2096-7446.2024.02.007 Abstract （96）            Knowledge map    Objective To clarify the risk factors of hypothermia in emergency trauma patients by meta-analysis. Methods The cohort studies and case-control studies on the risk factors of hypothermia in the trauma patients were searched by computer in CNKI，VIP，WanFang data，CBM，PubMed，Web of Science，Embase，and Cochrane Library. The search time was from the inception of databases until July 2023. After independent literature screening，data extraction，and quality evaluation by two researchers，RevMan 5.4.1 was used for meta-analysis. Results A total of 10 articles were included，including 8 risk factors：systolic blood pressure （OR=0.99），Revised Trauma Score （RTS） （OR =0.60），Injury Severe Score （ISS） （OR =1.02），patients lying on the ground when the ambulance arrived（OR =8.22），temperature （OR =0.95），winter（OR =2.20），warm measures during transport （OR =0.25） and pre-hospital intubation（OR=6.41）. Conclusion Systolic blood pressure，RTS，ISS，lying on the ground when the ambulance arrives，air temperature，winter，keeping warm during transport and pre-hospital intubation are the influencing factors of hypothermia in emergency trauma patients. It is suggested that nurses can rely on the influencing factors，take targeted preventive measures to reduce the incidence of hypothermia，thereby reducing the risk of death in trauma patients. Related Articles | Metrics

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Research progress on triage of emergency elderly trauma patients CHEN Chen, WAGN Mingming, WANG Min Chinese Journal of Emergency and Critical Care Nursing    2024, 5 (2): 137-141.   DOI: 10.3761/j.issn.2096-7446.2024.02.008 Abstract （109）            Knowledge map    With the aging population，the incidence and mortality rate of elderly trauma patients are increasing，and trauma has become the fifth leading cause of abnormal death in the elderly population. Pre-examination triage is the first line of defense for evaluating trauma patients，which prioritizes and grades the severity of the patient’s condition. This article elaborates on the age definition，triage criteria and assessment indicators，analyzes the relevant factors affecting the triage，and proposes future prospects，hoping to further establish and improve triage criteria for emergency elderly trauma patients. Related Articles | Metrics

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Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (6): 485-492.   Abstract （172）            Knowledge map    Related Articles | Metrics

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Meta-integration of a qualitative study on the experience of ethical dilemmas of ICU nurses YU Ran, GAN Qingwen, LIAN Zerong, SUN Xiaoxuan, LING Hua Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (11): 1000-1005.   DOI: 10.3761/j.issn.2096-7446.2023.11.007 Abstract （107）            Knowledge map    Objective To systematically evaluate ICU nurses’ experiences of moral dilemmas to inform the development of evidence-based interventions for moral dilemmas. Methods Computerized search of relevant databases for qualitative studies on ICU nurses’ experiences of ethical dilemmas was conducted with a time frame of construction to July 2023. The quality of the included literature was evaluated using the 2016 Australian Joanna Briggs Institute （JBI） Center for Evidence-Based Health Care qualitative research quality assessment tool，and the results were integrated using meta-integration methods. Results A total of 16 papers were included，54 findings were distilled，and 8 categories were grouped to form 3 integrated findings：negative physical，psychological，and cognitive behavioral experiences of ICU nurses；root causes of ethical dilemmas of ICU nurses；and ways of coping with ethical dilemmas of ICU nurses. Conclusion Nursing managers should pay attention to the physical and psychological discomfort experience brought by moral dilemmas to ICU nurses，and should use a variety of interventions to actively respond to moral dilemmas，so as to reduce the level of ICU nurses’ moral dilemmas and improve the quality of nursing services. Related Articles | Metrics

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Design and application of intra-hospital transport work instruction sheet for patients supported by extracorporeal membrane oxygenation CHU Junqing, LIN Yan, GAO Chunhua, REN Yayu, ZHANG Shuai, LI Xingjie, QIAO Wenbo Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (12): 1061-1067.   DOI: 10.3761/j.issn.2096-7446.2023.12.001 Abstract （161）            Knowledge map    Objective Design an intra-hospital transport work instruction sheet for patients supported by extracorporeal membrane oxygenation（ECMO） and evaluate its effect in clinical practice. Methods The hospital transport work instruction sheet of adult ECMO patients was designed by literature review，group discussion，expert meeting and so on. From January to December 2020，84 adult ECMO in-hospital transport patients in ICU ward of a tertiary class A hospital in Zhejiang Province were selected as the experimental group，was used intra-hospital transpor work instruction sheet. From January 2018 to December 2019，45 adult patients with ECMO intra-hospital transport were selected as the control group，and routine transport care was adopted. The incidence of transport- related adverse events and duration of in-hospital transport were compared between the two groups. Results The incidence rate of adverse events related to condition change，technology and movement，and transport time in experimental group were lower than those in control group（P<0.01）. Conclusion The use of intra-hospital transport work instruction sheet in adult ECMO patients can shorten the time of intra-hospital transport，reduce the incidence of transport-related adverse events，improve transport efficiency and ensure transport safety. Related Articles | Metrics

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Development of indicators for reviewing sleep promotion strategies in ICU awake patients and analysis of barrier factors GU Tiantian, CHEN Wei, LI Xiaojuan, CHEN Junxi Chinese Journal of Emergency and Critical Care Nursing    2024, 5 (2): 108-114.   DOI: 10.3761/j.issn.2096-7446.2024.02.002 Abstract （100）            Knowledge map    Objective To understand the current status of clinical application of the evidence on sleep promotion strategies for awake patients in ICU，analyze the barriers and facilitators，and initially formulate strategies for change，so as to provide references for the clinical translation of the evidence. Methods Through the pre-evidence summary，21 pieces of best evidence were included and 13 audit criteria with 22 audit indicators were developed for clinical audit，and based on the results of the audit，barriers and facilitators were analyzed and strategies for change were developed. Results The clinical implementation rate for the 22 audit indicators ranged from 0 to 100%，and 8 of the review entries had an implementation rate of 0 percent. The barrier factors were mainly the lack of knowledge of sleep management among ICU nurses，gaps in the relevant systems and processes in the department，and irrational settings in the ward environment，while facilitators were the good ability of the researcher and the team to translate the evidence，active support for change from the departmental administrators，the support of the hospital’s policy to build a humanistic ward，and the strong willingness of the nurses in the department to accept and support the change. Conclusion There is still a large gap between the evidence of sleep promotion strategies for awake patients in ICU and clinical practice，so a comprehensive and in-depth analysis of barrier and promotion factors should be conducted to formulate scientific and reasonable change strategies，promote the translation of evidence，and provide a reference basis for clinical practice. Related Articles | Metrics

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Summary of the best evidences for the management of the peri-extubation period for ICU adult patients with tracheal intubation ZHOU Hongfang, LAN Xuhong, JIA Donghui, WANG Qian, WANG Hengyang, ZHANG Ying, ZHANG Zhigang Chinese Journal of Emergency and Critical Care Nursing    2024, 5 (1): 33-39.   DOI: 10.3761/j.issn.2096-7446.2024.01.005 Abstract （150）            Knowledge map    Objective To search and summarize the best evidences for the management of the peri-extubation period for ICU adult patients with tracheal intubation，which will provide practical reference for clinical medical staff. Methods We systematically searched UpToDate，BMJ Best Practice，National Institute for Health and Clinical Excellence，Scottish Intercollegiate Guidelines Network，Guidelines International Network，US National Guideline Clearinghouse，Registered Nurses Association of Ontario，American Society of Intensive Care Medicine，European Society of Intensive，Medlive guide，Cochrane Library，PubMed，Embase，CINAHL，SinoMed，CNKI，VIP database， Wangfang database about Clinical decisions，guidelines，best evidences，systematic reviews，expert consensus related to the extubation period for adult patients with tracheal intubation，the retrieval period was from the date of inception to March，2023. Two reviewers independently screened the literatures and extracted data. Results 16 articles were included，with 5 clinical decisions，10 guidelines，and a systematic review. A total of 28 best evidences were collected from 6 subthemes and 3 themes，including before extubation (pre-extubation assessment，planning，readiness testing)，extubation and after extubation (monitoring，special populations，re-eating). Conclusion The best evidences summarized in this study can provide reference for medical staff to manage patients with high-risk failure of extubation and standardize the nursing during the extubation period. In clinical practice，it is necessary to combine the best evidences with specific situations，select and apply the evidences to improve patient prognosis and nursing quality. Related Articles | Metrics

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Nursing care of a trauma patient undergoing exploratory laparotomy within the trauma recovery unit under resuscitation balloon occlusion DING Youya, WANG Sa, YAN Danping, WANG Yuwei Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (12): 1112-1115.   DOI: 10.3761/j.issn.2096-7446.2023.12.009 Abstract （94）            Knowledge map    To summarize the emergency nursing experience of a patient with traumatic hemorrhagic shock who underwent exploratory laparotomy within the trauma recovery unit under resuscitation balloon occlusion. In response to issues such as the inability to maintain vital signs，rapid progression of the condition，the need to shorten preoperative preparation time and reduce transport risks in patients with traumatic hemorrhagic shock，exploratory laparotomy with resuscitation balloon occlusion was performed in the emergency trauma recovery unit. After symptomatic treatment and nursing，the patient’s vital signs tended to be stable，and was transferred to the intensive care unit for further treatment for 15 days before being transferred to the local hospital for rehabilitation. After discharge，the patient was followed up for 3 months and recovered well. Related Articles | Metrics

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Application of best evidence for aspiration prevention in patients with mechanical ventilation YAO Huan, FANG Jinyan, FU Rong, ZHONG Lijun, WAGN Xiaoyan, HUANG Ganying Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (9): 785-791.   DOI: 10.3761/j.issn.2096-7446.2023.09.003 Abstract （187）            Knowledge map    Objective To summarize and evaluate the application effects of the best evidence of aspiration pre- vention in adult patients with mechanical ventilation. Methods The best evidence for the prevention of aspiration in patients with mechanical ventilation was developed into an evidence-based practice plan by using the method of evidence-based nursing. After baseline review，obstacle factor analysis，and construction of the best evidence applica- tion strategy，the best evidence was implemented in the emergency intensive care unit of a tertiary hospital in Hangzhou from October 1 to November 20，2022. The incidence of aspiration in patients before and after evidence- based practice，the implementation rate of review indicators，and the scores of emergency intensive care unit nurses on the knowledge questionnaire of aspiration prevention and management in patients with mechanical ventilation were compared. Results Finally，23 evidences were included and 19 review indicators were formed. After evidence- based practice，the incidence of aspiration in patients with mechanical ventilation decreased from 21.43% to 6.67%，and the incidence of ventilator-associated pneumonia （VAP） decreased from 28.57% to 6.67%. Except for indicator 10 and 19，the implementation rate of the other review indicators increased to more than 90%. The score of nurses’ questionnaire on knowledge of aspiration prevention and management in patients with mechanical ventilation increased from （78.04±1.58） points to （91.04±0.98） points，and the difference was statistically significant （t=-11.879，P＜0.001）. Conclusion Applying the best evidence to clinical nursing practice is conducive to reduce the incidence of aspiration in patients with mechanical ventilation，improve the quality of clinical nursing. Related Articles | Metrics

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Translation and psychometric test of the Chinese version of the Stressor Scale for Emergency Nurses ZHANG Mengjie, LI Ke, ZHANG Jianxia, LI Ning, YU Miao, YANG Zhennan Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (12): 1105-1111.   DOI: 10.3761/j.issn.2096-7446.2023.12.008 Abstract （95）            Knowledge map    Objective To translate and test the reliability and validity of the Chinese version of the Stressor Scale for Emergency Nurses （SSEN）. Methods The Brislin translation method was used to translate the SSEN scale literally，back-translate and cross-culturally adjust to the Chinese version of the SSEN. Thirty emergency nurses were selected for pre-survey，after modifying the survey results，the reliability and validity of the Chinese version of SSEN was tested among 317 emergency nurses by convenient sampling in several tertiary general hospitals in in Beijing. Results The Chinese version of SSEN includes life and death situation，patients’ andfamilies’ actions and reactions，technical and formal support，conflicts，total 4 dimensions，24 items. The Scale-Content Validity Index（S-CVI） was 0.94，and Item-Content Validity Index（I-CVI） was 0.83 to 1.00. Four common factors were extracted by exploratory factor analysis，and the cumulative variance contribution rate was 76.730%. The Cronbach’s α for the total scale was 0.960，and the split-half reliability was 0.840. Conclusion The Chinese version of SSEN has acceptable reliability and validity，It can be used to measure the pressure source of emergency nurses， effectively evaluate the pressure state of emergency nurses，and provide a basis for nursing managers to intervene. Related Articles | Metrics

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Construction and validation of a nomogram risk prediction model for subsyndromal delirium in mechanically ventilated patients GU Tiantian, CHEN Junxi, YANG Yang, XIAO Xu, LI Jiao, ZHANG Yongmei Chinese Journal of Emergency and Critical Care Nursing    2023, 4 (12): 1068-1074.   DOI: 10.3761/j.issn.2096-7446.2023.12.002 Abstract （106）            Knowledge map    Objective To analyze the risk factors for the occurrence of subsyndromal delirium in mechanically ventilated patients and construct a nomogram risk prediction model to predict the occurrence of subsyndromal delirium. Methods Convenience sampling was used to select 434 mechanically ventilated patients admitted to the ICU of a tertiary hospital in Guizhou Province from July 2021 to June 2022，who were categorized into the subdelirium syndrome group （n=136） and the non-subdelirium syndrome group （n=298） using the ICU Patient Ambi- guity of Consciousness Assessment Scale. We explored the independent risk factors for the occurrence of subde- lirium syndrome through univariate and multifactorial logistic regression analyses，established a risk prediction model，developed a nomogram，and validated the model both internally and externally. Results Multifactorial logistic regression analysis revealed that age（OR=1.029），acute physiological and chronic health status score（OR=1.267）， whether restrained（OR=1.029），intensive care pain score（OR=2.487），Richards-Campbell sleep scale score（OR=1.150）， Richmond agitation-sedation score（OR=1.500） were independent risk factors for the development of subdelirium. The consistency index of the nomogram model for the occurrence of subdelirium in mechanically ventilated patients in the ICU was 0.956，with a sensitivity of 86.2% and a specificity of 94.1%. Conclusion The risk prediction model construc- ted in this study can effectively predict the occurrence of subdelirium syndrome in mechanically ventilated patients， which provides a reference for clinical medical personnel to scientifically predict the occurrence of subdelirium. Related Articles | Metrics