Table of Content

10 October 2026, Volume 7 Issue 10 Previous Issue   

Research Paper

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Effect of goal-oriented ultrasound protocol on preventing unplanned discontinuation of continuous renal replacement therapy in ICU patients JIA Bentao, XU Nan, DONG Tianju, LI Zhangshuangzi, TAN Wanlin, LUO Shangrong, QIAO Guojin, PI Jianhua, WANG Mei 2026, 7 (10):  1157-1163.  doi: 10.3761/j.issn.2096-7446.2026.10.001 Abstract ( )   HTML ( )   PDF (1239KB) ( )   Save Objective To explore the application effect of a goal-oriented ultrasound protocol in preventing unplanned discontinuation of continuous renal replacement therapy（CRRT） among patients in the intensive care unit （ICU）. Methods The goal-oriented ultrasound protocol was developed through literature review and expert consultation. A total of 120 eligible patients receiving CRRT in the ICU of Affiliated Hospital of Guizhou Medical University from January 2024 to June 2025 were consecutively enrolled. After all subjects were recruited，patients were randomly assigned to the experimental group and control group by random number table，with 60 cases in each group.The control group received conventional CRRT management，while the experimental group received a goal-oriented ultrasound protocol，including risk stratification assessment prior to discontinuation，targeted monitoring，and intervention measures. The incidence of unplanned discontinuation，filter usage duration，precision of fluid balance，and ICU hospitalization duration were compared between the two groups. Results The incidence of unplanned CRRT discontinuation in the experimental group was 11.67%，which was significantly lower than 28.33% in the control group（P<0.05）. The average filter service time and the compliance rate of fluid balance in the experimental group were significantly higher，while the average length of ICU stay was significantly shorter than those in the control group（P<0.05）. Conclusion The goal-oriented ultrasound protocol can effectively reduce the risk of unplanned CRRT discontinuation，prolong filter service life，optimize fluid management，and provide a reference for improving clinical prognosis of ICU critically ill patients. Figures and Tables | References | Related Articles | Metrics

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Research on the construction of user profiles for self-management behaviors of patients with postoperative deep vein thrombosis after spinal degeneration HAN Li, ZHOU Dan, QI Siyu, SHI Changfang, LIU Meizi, TANG Chi, ZHAO Aiping, WANG Ronghuan, ZHU Kai 2026, 7 (10):  1164-1170.  doi: 10.3761/j.issn.2096-7446.2026.10.002 Abstract ( )   HTML ( )   PDF (1727KB) ( )   Save Objective To explore the different types of self-management behaviors of patients with postoperative deep vein thrombosis after spinal degenerative diseases based on user profiling technology，thereby providing the basis for the design of precise intervention plans. Methods The purposive sampling method was used to select 23 patients with postoperative deep vein thrombosis due to spinal degenerative diseases for semi-structured interviews. The data were managed and coded using NVivo 12.0 software，and analyzed along with theme extraction through Colaizzi’s seven-step analysis method. The self-management behavior characteristics of patients with deep vein thrombosis after spinal degenerative disease surgery were manually extracted，and the patient self-management personas were visualized in a comprehensive form combining character images and user tags. Results The patient self-management persona tags for self-management of patients with postoperative deep vein thrombosis due to spinal degenerative diseases can be summarized into five dimensions：disease cognition and information needs，risk perception and behavioral decisions，multiple barriers to self-management，diversified coping strategies and support needs，and bidirectional responses in terms of psychological emotions. The types of patient self-management personas include five categories：those with weak cognition and lack of motivation，those actively seeking health management cooperation，those with psychological vulnerability and behavioral dependence，those with strong will but limited resources，and those who are blindly optimistic and indifferent to risks. Conclusion The self-management personas of patients with postoperative deep vein thrombosis after spinal degenerative diseases exhibit group heterogeneity. Therefore，precise and personalized intervention strategies should be provided based on the different profiles of each patient. Figures and Tables | References | Related Articles | Metrics

Special Planning-Nursing Care for Cardiovascular and Cere-brovascular Emergencies and Critical llnesses

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The application of family surrogate decision aid for intravenous thrombolysis in acute ischemic stroke patients XUE Haiyan, ZHU Yafang, ZHANG Meng, TAN Liping, LU Juan 2026, 7 (10):  1171-1178.  doi: 10.3761/j.issn.2096-7446.2026.10.003 Abstract ( )   HTML ( )   PDF (1378KB) ( )   Save Objective To develop a decision aid for family surrogate decision makers with intravenous thrombolysis in acute ischemic stroke（AIS） patients，and explore its preliminary clinical application effects. Methods The final version of the decision aid was developed through preliminary qualitative research，evidence synthesis，expert consultation，and user testing. A quasi-experimental study design was employed. From February to November 2024，62 AIS patients and their family surrogate decision-makers were recruited from the emergency department of a tertiary-level hospital in Suzhou. The control group received standard medical and nursing care，while the intervention group received decision aid in addition to standard care. The study compared post-intervention scores on the decision dilemma and decision satisfaction scales，as well as decision-making duration between the two groups of family surrogate decision-makers. Results The experimental group demonstrated significantly reduced decision dilemma，decision-making time among family surrogate decision-makers and increased decision satisfaction（P<0.05）. Conclusion The AIS intravenous thrombolysis family surrogate decision aid effectively reduces decision dilemmas and time among family surrogate decision-makers while enhancing decision satisfaction. Figures and Tables | References | Related Articles | Metrics

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Investigation on self-efficacy and analysis of influencing factors in patients with acute cerebral infarction after thrombolytic therapy CAI Xun, LIU Cairong, HUANG Qin 2026, 7 (10):  1179-1186.  doi: 10.3761/j.issn.2096-7446.2026.10.004 Abstract ( )   HTML ( )   PDF (1321KB) ( )   Save Objective To explore the level of self-efficacy in patients with acute cerebral infarction（ACI） after intravenous thrombolytic therapy and the influencing factors，in order to provide a basis for the targeted formulation of psychological intervention and rehabilitation support strategies，to enhance the patients’ confidence in recovery and promote the recovery of neurological function. Methods By using the continuous sampling method，300 patients with acute cerebral infarction（ACI） who received intravenous thrombolysis treatment in a tertiary grade A hospital in Nanjing from January 2023 to January 2025 were selected as the research subjects. The General Self-Efficacy Scale（GSES） questionnaire was used to assess the patients one month after thrombolysis. The patients were divided into the group with good self-efficacy and the group with low self-efficacy based on the scores. Univariable and multivariable logistic regression analysis were used to investigate the factors related to the low self-efficacy of ACI patients after intravenous thrombolysis. Results The GSES score of 300 ACI patients was（25.47±5.61） one month after thrombolysis，237（79.00%） patients had good self-efficacy，while 63（21.00%） had poor self-efficacy. Compared with the group with good efficacy，patients in the group with low efficacy had higher NIHSS scores，negative coping scores，anxiety scores，a higher proportion of poor vascular recanalization，and lower social support scores（P<0.05）. Multivariable logistic regression model analysis showed that NIHSS score（OR=1.058），coping style （OR=1.085），social support（OR=0.867），anxiety（OR=1.077），and poor vascular recanalization（OR=3.093） were all associated factors for low self-efficacy in ACI patients one month after thrombolysis（P<0.05）. and anxiety（OR=1.077） were all related factors for low self-efficacy in ACI patients after thrombolytic therapy（P<0.05）. Conclusion At the assessment point one month after thrombolysis，a significant number of patients with ACI still exhibited low self-efficacy. Higher NIHSS score，tendency towards negative coping style，severe anxiety，and poor vascular recanalization were all risk factors for low self-efficacy. Higher level of social support was a protective factor. It is recommended that in the acute rehabilitation management，psychological counseling，social support reinforcement and cognitive behavioral intervention should be combined in the early stage to enhance their rehabilitation confidence and self-management ability，thereby optimizing the long-term prognosis. Figures and Tables | References | Related Articles | Metrics

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Analysis of the current situation and influencing factors of emergency triage nurses’ identification of stroke patients ZHANG Renmin, WANG Mingming, WANG Peng, TANG Shuting, CHEN Yan, LING Yajing 2026, 7 (10):  1187-1193.  doi: 10.3761/j.issn.2096-7446.2026.10.005 Abstract ( )   HTML ( )   PDF (1143KB) ( )   Save Objective To investigate the current situation of emergency triage nurses’ correct identification of stroke patients and the risk factors，so as to provide a reference for further optimizing the emergency triage and screening process for stroke patients. Methods A retrospective analysis was conducted on the clinical data of 391 stroke patients in the emergency triage of a tertiary hospital in Zhenjiang from September to December 2024. Logistic regression analysis was used to screen the influencing factors of correct identification by triage nurses. Results The patients were divided into a correct identification group（197 cases） and an incorrect identification group（194 cases） based on whether the triage nurses correctly identified the stroke patients. The correct identification rate of stroke patients by emergency triage nurses was 50.3%. There were statistically significant differences between the two groups in terms of unilateral limb weakness or numbness，unilateral facial numbness or deviation of the mouth corner，unclear speech，dizziness or vertigo，nausea and vomiting，consciousness disorder，headache，history of diabetes，history of atrial fibrillation，finger pulse oxygen saturation，and whether the on-duty triage nurse was a specialized emergency nurse（P<0.05）. Further logistic regression analysis showed that unilateral limb weakness or numbness（OR=0.498），dizziness or vertigo（OR=5.702），consciousness disorder（OR=3.927），history of atrial fibrillation（OR=0.332），and the triage nurse being a specialized emergency nurse（OR=0.336） were independent influencing factors for the correct identification of stroke patients by the emergency triage nurse（P<0.05）. Conclusion Emergency triage nurses have a relatively high correct recognition rate for typical symptoms of stroke，but a relatively low correct recognition rate for atypical symptoms. It is suggested to conduct more in-depth inquiries and physical examinations for high-risk groups such as those with atrial fibrillation or dizziness，and to equip emergency rescue specialist nurses，to establish a management mechanism for emergency triage of stroke in hospitals at all levels，and promote the standardization of triage process for stroke. Figures and Tables | References | Related Articles | Metrics

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The application of drone-delivered automated external defibrillators in out-of-hospital cardiac arrest：a scoping review WANG Haizhen, WU Jinjing, SONG Yuan, CHENG Pengfei, FENG Xiuqin 2026, 7 (10):  1194-1200.  doi: 10.3761/j.issn.2096-7446.2026.10.006 Abstract ( )   HTML ( )   PDF (1175KB) ( )   Save Objective To systematically review and analyze current studies on the application of drone-delivered automated external defibrillators in out-of-hospital cardiac arrest（OHCA） scenarios. Methods Following the Arksey and O’Malley framework for scoping reviews，a comprehensive search was conducted in both Chinese and international databases，including CNKI，Wanfang，Pubmed，Embase，Cochrane Library，Web of Science，MEDLINE，and Scopus，covering literature published up to June 30，2025. Two independent reviewers screened，extracted，and synthesized the data from the included studies. Results A total of 14 studies were included. The findings demonstrate that drones possess good flight stability and response capability，with delivery success rates ranging from 81% to 100%. Compared to traditional emergency medical services（EMS），drones significantly reduced AED delivery times in specific settings such as rural，semi-urban，and traffic-congested areas. Conclusion Drone-based AED delivery shows promising technical feasibility and relative time-saving advantages in prehospital emergency care for OHCA，particularly in regions with limited EMS resources. Figures and Tables | References | Related Articles | Metrics

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Temperature management strategies for out-of-hospital cardiac arrest patients in the emergency setting：a scoping review WANG Yuwei, WANG Sa, XU Shurong, YAN Danping, ZHOU Shuaishuai, LIU Yajie, WANG Meiling 2026, 7 (10):  1201-1208.  doi: 10.3761/j.issn.2096-7446.2026.10.007 Abstract ( )   HTML ( )   PDF (1079KB) ( )   Save Objective To review and summarize temperature management strategies for patients with out-of-hospital cardiac arrest（OHCA） in the emergency setting. Methods According to the research specifications of scoping reviews，we systematically searched eight databases（PubMed，Web of Science，CNKI，Wanfang and etc.） from inception to June 24，2025. Eligible studies were reviewed to synthesize evidence on target temperature ranges，cooling techniques，monitoring modalities，and pharmacological interventions for OHCA patients in emergency departments. Results A total of 25 studies was included. All temperature management strategies focused on cooling，primarily via cold saline infusion and surface cooling. Commonly reported monitoring methods included bladder，esophageal，and tympanic temperature measurements. Frequently used pharmacological agents were sedatives，analgesics，and muscle relaxants；however，their timing and dosing varied considerably across studies. Conclusion The exploration of temperature regulation in the emergency treatment of OHCA patients is limited by factors such as region，system，and hardware conditions，and remains insufficiently in-depth. There are considerable disparities across different regions，and few relevant reports have been published both domestically and internationally in the past five years，leaving a research gap. Future research should further explore temperature management strategies and monitoring approaches tailored to the resources of different healthcare systems. Figures and Tables | References | Related Articles | Metrics

Emergency Care Research

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Emergency nursing for a patient with hemorrhagic shock caused by spontaneous liver rupture after kidney transplantation JIANG Qiaoling, LU Ting, FENG Lili, SUN Li, HAN Zhijian, ZHOU Yuehong 2026, 7 (10):  1209-1211.  doi: 10.3761/j.issn.2096-7446.2026.10.008 Abstract ( )   HTML ( )   PDF (781KB) ( )   Save To summarize the nursing of a patient with spontaneous liver rupture and hemorrhagic shock after kidney transplantation. Given the rarity，early diagnostic difficulty，and multiple dilemmas（shock resuscitation vs. renal protection，coagulopathy vs. immunosuppressant blood drug concentration stability，immunosuppression vs. infection risk of multiple catheters），we implemented nurse-led multidisciplinary rapid response for clarifying shock identification measures，staged volume management with the "transplant kidney perfusion safety window" as the core to balance resuscitation and functional protection of the transplant kidney，stepwise transfusion based on dynamic coagulation monitoring to precisely correct coagulation dysfunction，strengthening the monitoring of tacrolimus blood drug concentration to prevent drug toxicity，“space-time zoning” infection prevention and control to reduce the risk of multi-channel infection. For the patient with hearing loss，multi-mode communication and intelligent follow-up continuous care were implemented. Through systematic intervention，the patient survived the critical phase，was discharged on postoperative day 43，and had normal graft（serum creatinine 107 μmol/L） and liver function at 3 month follow-up. References | Related Articles | Metrics

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Practice of treating a patien with severe penetrating craniocerebral injury relying on the medical-police collaboration model and information-based early warning platform YUAN Yuehai, ZHENG Fengmin, YANG Minfei, YAO Xiaoyue, ZHAO Yanxiang 2026, 7 (10):  1212-1215.  doi: 10.3761/j.issn.2096-7446.2026.10.009 Abstract ( )   HTML ( )   PDF (714KB) ( )   Save This paper summarized the emergency care experience of a patient with penetrating craniocerebral injury relying on the medical-police collaborative model and information-based early warning platform. Given the rarity of craniocerebral penetrating injuries，the rapid progression and ever-changing condition of the disease，and the urgent need for professional trauma teams to assess and expedite emergency surgical procedures，measures such as establishing a police-medical collaborative rescue platform to shorten pre-hospital transfer time，moving triage forward to optimize the rescue process，effectively fixing exposed foreign objects to reduce secondary injuries，maintaining airway patency and implementing stepwise respiratory support management，and using air suspension transfer technology for safe transportation were adopted. Through efficient teamwork and technological innovation，the patient was discharged 12 days after surgery and was able to take care of themselves six months after discharge during follow-up. Figures and Tables | References | Related Articles | Metrics

Critical Care Research

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Nursing for living-donor liver transplantation in a child with recurrent hepatoblastoma complicated by invasive pulmonary aspergillosis LEI Lei, GUO Yu, SHI Liangliang, ZHANG Jianguo, GAO Lijun, LIANG Xue 2026, 7 (10):  1216-1218.  doi: 10.3761/j.issn.2096-7446.2026.10.010 Abstract ( )   HTML ( )   PDF (551KB) ( )   Save This article summarized the perioperative nursing experience for a pediatric patient undergoing living donor liver transplantation，who presented with recurrent hepatoblastoma complicated by invasive pulmonary aspergillosis，congenital bronchopulmonary dysplasia，and incomplete right bundle branch block. Key nursing interventions included airway management based on lung-protective strategies，immediate postoperative extubation followed by sequential high-flow nasal oxygen therapy；goal-directed hemodynamic monitoring and fluid management；collaborative monitoring of immunosuppressive and antifungal therapy by nurses，physicians，and pharmacists；a tripartite infection prevention and control approach focusing on environment，procedures，and personnel. Through these comprehensive nursing interventions，the child was discharged successfully 32 days after surgery and remained in good general condition at the 5-month follow-up. References | Related Articles | Metrics

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Nursing care of a patient with neurofibromatosis type 1 complicated by severe cervical kyphosis and epilepsy WU Jinjuan, MA Yaojing, YU Qunfei, YE Qun, WANG Manman, TAO Yiqing 2026, 7 (10):  1219-1221.  doi: 10.3761/j.issn.2096-7446.2026.10.011 Abstract ( )   HTML ( )   PDF (772KB) ( )   Save To summarize the nursing experience of one patient with extremely severe cervical kyphosis secondary to neurofibromatosis type 1 complicated with epilepsy who underwent combined anterior and posterior cervical spine surgery. In view of the nursing difficulties such as great difficulty in preoperative traction，high risk of acute epileptic seizures，and easy occurrence of neck hematoma and airway obstruction，precise nursing for skull-pelvic ring gravity traction was implemented before the operation，a “three-dimensional” protection system for epilepsy was established，and proactive risk prevention and control during the perioperative period were well done. After surgery，measures such as standardized airway crisis early warning management，early identification of neck hematoma，combined with goal-oriented analgesia and personalized resistance training programs，and stepwise collaborative prevention and control of complications were adopted. After 18 days of individualized treatment and nursing，the patient successfully recovered and was discharged from the hospital，with good recovery during follow-up. References | Related Articles | Metrics

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Nursing care of graded physical restraint in a patient with psychiatric symptoms due to polyomavirus brainstem encephalitis undergoing therapeutic plasma exchange GUO Xiang, CHEN Qiaoling, WU Yongjia, ZHU Xuanjing, LI Miao, LIU Fang 2026, 7 (10):  1222-1225.  doi: 10.3761/j.issn.2096-7446.2026.10.012 Abstract ( )   HTML ( )   PDF (666KB) ( )   Save To summarize the nursing experience of a patient with psychiatric symptoms caused by polyomavirus brainstem encephalitis undergoing therapeutic plasma exchange（TPE） with graded physical restraint. To address challenges such as patients’ psychiatric behavioral abnormalities，suboptimal sedation efficacy，and low treatment compliance，the nursing team established a risk-assessment-based graded physical restraint strategy before plasma exchange. During the procedure，we strictly implemented graded physical restraint management，while prioritizing alternative restraint strategies during the treatment interval. No unplanned extubation occurred during the entire treatment process，with a 100% treatment completion rate and no complications related to physical restraints. After 21 days of ICU monitoring and treatment，the patient’s distal limb muscle strength improved，with the Glasgow score restored to 15 points，and regained consciousness. The patient was then transferred to the general ward of the neurology department for further treatment. References | Related Articles | Metrics

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Nursing care for one case of systemic sclerosis treated with chimeric antigen receptor T-cell complicated with cytokine release syndrome LU Chunning, REN Huanhuan, GAO Chao, XU Liling 2026, 7 (10):  1226-1228.  doi: 10.3761/j.issn.2096-7446.2026.10.013 Abstract ( )   HTML ( )   PDF (571KB) ( )   Save This report summarized the nursing management of cytokine release syndrome （CRS） in a patient with systemic sclerosis following chimeric antigen receptor T-cell （CAR-T） therapy. Given the patient’s severe baseline condition，rapid CRS progression，and complications including mucocutaneous injury and immunosuppression，a nursing-led CRS early-warning system was established. Refined infection prevention and control，and coordinated mucocutaneous repair strategy were implemented. The patient successfully navigated the acute phase post-CAR-T infusion，with progressive normalization of laboratory parameters，significant healing of oral ulcers，and improvement in skin induration. The patient was discharged on day 20 after infusion. References | Related Articles | Metrics

Quality and Safety

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Development and psychometric test of Supportive Care Needs Scale for patients with severe acute pancreatitis after intensive care unit discharge LI Wen, XU Yihong, WANG Jianan, YANG Zhichao, XU Hongxia, PAN Hongying 2026, 7 (10):  1229-1234.  doi: 10.3761/j.issn.2096-7446.2026.10.014 Abstract ( )   HTML ( )   PDF (1147KB) ( )   Save Objective To develop a supportive care needs scale for patients with severe acute pancreatitis （SAP） after discharge from the ICU and to test its reliability and validity. Methods Guided by the supportive care framework，an initial scale was developed through literature review，qualitative interviews，expert panel discussions，and a Delphi expert consultation. Using convenience sampling，330 SAP patients transferred out of the ICU were surveyed with questionnaires based on inclusion and exclusion criteria from January to October 2024 to test the scale’s reliability and validity. Results The final Supportive Care Needs Scale for SAP patients after ICU discharge consisted of 38 items across 4 dimensions. The cumulative contribution rate of variance after rotation was 63.812%. The scale-level content validity index was 0.902 and the average was 0.989. The item-level content validity index ranged from 0.875 to 1.000. The overall Cronbach’s α coefficient for the scale was 0.958，with dimension-specific coefficients ranging from 0.917 to 0.962. The overall split-half reliability of the scale was 0.976，with dimension-specific values ranging from 0.933 to 0.967. The overall test-retest reliability was 0.982，with dimension-specific values ranging from 0.803 to 0.954. Conclusion The scale demonstrated good reliability and validity，indicating its suitability for scientifically assessing the content and level of supportive care needs in SAP patients after ICU discharge. Figures and Tables | References | Related Articles | Metrics

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Calculation and simulation study of optimal window numbers for emergency triage based on queuing theory LI Rui, ZHOU Lijin, ZHANG Yue 2026, 7 (10):  1235-1242.  doi: 10.3761/j.issn.2096-7446.2026.10.015 Abstract ( )   HTML ( )   PDF (1201KB) ( )   Save Objective To construct a quantitative relationship model between the number of emergency triage windows and patient arrival rates，and to propose dynamic optimization strategies for multiple scenarios，thereby providing a data-driven decision-making tool for emergency workforce allocation. Methods A retrospective analysis was conducted on the full-year 2024 emergency department data from a tertiary-grade A hospital in Shanghai. Based on the multi-queue multi-server M/M/S queuing model，a static calculation formula for the optimal number of triage windows was derived. Subsequently，Anylogic simulation software was employed to construct a dynamic simulation model covering three typical scenarios—routine triage，ambulance surge，and febrile patient diversion—to validate and refine the static formula. Finally，a three-level graded load response strategy was proposed based on the simulation results. Results Patient arrivals exhibited diurnal and seasonal bimodal peaks，with an average triage service time of （127.56±26.48） seconds. For the routine triage scenario，a linear configuration function was fitted：y= 0.035x+0.5，where y represents the number of triage nurses and x denotes the number of patient arrivals per hour. Simulation validation showed an overall root mean square percentage error（RMSPE） of 4.5%，outperforming the static model alone（RMSPE=12.3%）. For the ambulance surge scenario，a bivariate dynamic formula was proposed：Nwindows=λ/30+0.3·Pambulance·λ（where Pambulance represents the proportion of ambulance arrivals），which reduced offload delay by 46.9% compared with the static formula. For the febrile patient diversion scenario，owing to increased screening complexity，the window requirement followed a quadratic function：Nwindows=0.000 08λ2+ 0.016λ+1.2. Conclusion The integrated “static plus dynamic” model developed in this study provides a quantifiable，progressive decision-making tool for emergency triage workforce allocation，facilitating the transition of emergency management from experience-driven to data-driven approaches. As a single-center retrospective study，the generalization of the model to non-tertiary hospitals and other regions requires further validation. Future multicenter studies incorporating cost-effectiveness analysis are warranted to optimize model parameters and promote broader applicability. Figures and Tables | References | Related Articles | Metrics

Career Development of Nurses

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Application and evaluation of 3D panoramic view combined with hologram teaching in emergency competency training of nursing undergraduates MA Xiaoli, FAN Luo, ZHANG Yayun, YAN Fanghong, CAO Pengfei, ZHANG Yimei, HAN Xiaoyan, JIN Kangqi, JIN Hongying 2026, 7 (10):  1243-1248.  doi: 10.3761/j.issn.2096-7446.2026.10.016 Abstract ( )   HTML ( )   PDF (1068KB) ( )   Save Objective To develop and implement 3D panoramic view combined with holographic imaging teaching program，and to explore the application effect in the emergency competency training of undergraduate nursing students. Methods A multidisciplinary research team was established to develop a 3D panoramic view combined with holographic imaging teaching program. The undergraduate nursing students who practiced in the emergency department of a grade A tertiary hospital in Gansu Province from June 2023 to May 2025 were enrolled as research subjects. The experimental group adopted the 3D panoramic view combined with holographic imaging teaching program，while the control group implemented the conventional emergency nursing teaching program. The scores of clinical emergency ability，critical thinking ability，and self-directed learning ability of the two groups of nursing students were compared before and after the intervention. Results A total of 121 undergraduate nursing students were included in the study，including 60 cases in the experimental group and 61 cases in the control group. After the intervention，the total scores of clinical emergency ability，critical thinking ability，and self-directed learning ability assessment in the experimental group were significantly higher than those in the control group，with statistically significant differences（t values were 18.99, 20.64, and 26.26，respectively，all P<0.001）. Moreover，the scores of all dimensions of the above scales in the experimental group were also higher than those in the control group，with statistically significant differences（all P<0.001）. Conclusion The teaching mode of 3D panoramic view combined with holographic imaging can significantly enhance the clinical emergency ability，critical thinking ability，and self-directed learning ability of nursing students，providing empirical evidence for optimizing the emergency training program for nursing interns. Figures and Tables | References | Related Articles | Metrics

Evidence Synthesis Research

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Best evidence summary and clinical decision-making pathway construction of early trophic enteral nutrition in adult critically ill patients HU Enhui, PAN Xi, XU Lan, WANG Zhi 2026, 7 (10):  1249-1257.  doi: 10.3761/j.issn.2096-7446.2026.10.017 Abstract ( )   HTML ( )   PDF (1331KB) ( )   Save Objective To systematically retrieve，evaluate and integrate the best evidence for early trophic enteral nutrition in adult critically ill patients，and construct a decision-making pathway based on this evidence，so as to provide a basis for clinical nutrition management. Methods According to the "6S" model，domestic and foreign databases，guidelines and relevant websites were systematically searched to obtain clinical decisions，guidelines，expert consensuses and systematic reviews related to early trophic enteral nutrition in adult critically ill patients. The retrieval time limit was from the establishment of the database to October 2，2025. Researchers trained in evidence-based practice completed the summary of the best evidence，and constructed a clinical decision-making pathway diagram based on the summary. Results A total of 21 literatures were finally included，consisting of 1 clinical decision，8 guidelines，5 expert consensuses and 7 systematic reviews. A total of 18 pieces of evidence were summarized from 5 aspects：risk assessment，timing and route，target energy and protein，delivery rate and mode，as well as monitoring and management. On this basis，a clinical decision-making pathway diagram for early trophic enteral nutrition support in adult critically ill patients was constructed. Conclusion This study integrates the relevant evidence for early trophic enteral nutrition in adult critically ill patients and constructs a clinical decision-making diagram accordingly，which provides an evidence-based reference for clinical practice. It is recommended that clinical practice transformation should be combined with specific scenarios，and targeted selection and application should be carried out to ensure the effective implementation of measures and improve the prognosis of patients. Figures and Tables | References | Related Articles | Metrics

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Self-management experiences of patients undergoing hematopoietic stem cell transplantation：a meta-synthesis of qualitative research PAN Zhengwen, ZHOU Xiaoyu, ZHOU Weiwei, ZENG Liying, PANG Weilin, ZHANG Jianli, XU Liwei 2026, 7 (10):  1258-1265.  doi: 10.3761/j.issn.2096-7446.2026.10.018 Abstract ( )   HTML ( )   PDF (1188KB) ( )   Save Objective To systematically integrate the self-management experiences of patients undergoing hematopoietic stem cell transplantation（HSCT），providing a basis for the subsequent development of patient-centered self-management intervention programs. Methods Systematic search was conducted in PubMed，Cochrane Library，Embase，CINAHL，Web of Science，Scopus，China National Knowledge Infrastructure（CNKI），Wanfang Database，VIP Database，and Chinese Biomedical Literature Database for qualitative studies on the self-management experiences of patients undergoing hematopoietic stem cell transplantation. The search time limit was from the establishment of the database to June 30，2025. The quality of the literature was evaluated using the quality assessment criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center. The results were synthesized and integrated using the convergent integration method. Results A total of 7 articles were included，and 31 research results were extracted and classified into 10 new categories，which were then synthesized into 2 integrated results，namely barriers and facilitators of self-management in HSCT patients. Conclusion Healthcare providers should attach importance to the self-management experience of HSCT patients，fully leverage the role of the promoting factors of self-management experience，promptly identify the hindering factors of self-management experience，and provide self-management support to enhance the self-management ability of HSCT patients. Figures and Tables | References | Related Articles | Metrics

Review

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Clinical observation competence of critical care nurses：a concept analysis ZHAO Qi, JIN Yanhong, YANG Xiaowen, ZHONG Lixia, GAO Xi 2026, 7 (10):  1266-1271.  doi: 10.3761/j.issn.2096-7446.2026.10.019 Abstract ( )   HTML ( )   PDF (1091KB) ( )   Save Objective This study aims to analyze and clarify the conceptual content of clinical observation competency among critical care nurses in order to address the current issues of vague conceptual definitions and the lack of a unified framework. Methods A systematic search was conducted in PubMed，Cochrane Library，CINAHL，Web of Science，Embase，ProQuest，CNKI，Wanfang and VIP Database for studies related to the clinical observation competence of critical care nurses. The search timeframe spanned from the establishment of each database up to 30 September 2025. The selection of literature was conducted in accordance with a predetermined set of inclusion and exclusion criteria. Rodgers’ evolutionary concept analysis was applied to code，extract，and synthesize the findings from the 34 included studies. Results The clinical observation competence of critical care nurses comprises five conceptual attributes：systematic critical care knowledge and skills，continuous dynamic perception and information collection，integration of holistic perspective and critical thinking，efficient communication interaction and collaboration，proactive reflection，summarization and learning awareness. These attributes are interrelated and collectively form a complete cognitive-practice process from perception and judgment to action and reflection. Antecedents include individual，organizational，and environmental and task factors，while consequences involve improved patient safety and outcomes，and enhanced professional efficiency development. Conclusion This study clarifies that the concept of clinical observation competence of critical care nurses is a multidimensional professional competency integrating knowledge，skills，thinking，behaviors，and reflection，thereby providing a theoretical foundation for developing assessment tools and constructing structured training programs. The results of this conceptual analysis are limited by the era and technology. In the future，they will need to be refined and validated further in conjunction with new technological applications，such as artificial intelligence. Figures and Tables | References | Related Articles | Metrics

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Temperature management in continuous renal replacement therapy：a scoping review YU Zhenyuan, ZHANG Yulin, YUAN Jinjing, GU Zixin, TANG Huan, SHEN Yonghong 2026, 7 (10):  1272-1280.  doi: 10.3761/j.issn.2096-7446.2026.10.020 Abstract ( )   HTML ( )   PDF (1213KB) ( )   Save Objective To explore body temperature trends during continuous renal replacement therapy（CRRT），identify hypothermia risk factors and preventive strategies，assess the effects of varying temperature settings on thermoregulation，and propose an integrated temperature management framework for CRRT. Methods Following a scoping review approach，we systematically searched Web of Science，PubMed，Cochrane Library，Embase，Ovid，CNKI，VIP，and Wanfang databases.The retrieval time limit was from the establishment of the database to November 22，2024. Eligible articles were screened，summarized，extracted，and synthesized according to inclusion and exclusion criteria. Results A total of 38 studies were included. The findings indicated that body temperature in CRRT patients showed a declining trend during the initial 12 hours of treatment，with the most significant drop occurring within the first 4 hours. Risk factors for hypothermia included shock，advanced age，fluid imbalance，use of vasoactive agents，higher severity scores，prolonged CRRT duration，treatment modality and dose，and the type of heating method used during CRRT. In contrast，protective factors included higher body weight，higher mean arterial pressure（MAP），and higher baseline body temperature. Preventive strategies primarily included heating replacement fluids，using forced-air warming devices，and preheating infusions，with forced-air warming devices showing comparatively better thermal maintenance. Conclusion During CRRT，patients’ body temperature typically shows an initial decline，gradually stabilizes，and eventually recovers after treatment. Therefore，it is recommended to implement individualized warming interventions for high-risk patients within the first 2-4 hours of therapy and to select optimal warming devices and techniques. Future research should clarify the role of the interaction effect of temperature setting and treatment duration in preventing hypothermia and hypotension in the early stage of CRRT，especially focusing on the intervention timing and adaptability of specific subgroups such as mechanical ventilation，so as to optimize the temperature management strategy. Figures and Tables | References | Related Articles | Metrics