Objective To evaluate the implementation effect of an early activity multidisciplinary collaboration model based on the framework of the interprofessional collaborative team development theory in ICU mechanically ventilated patients. Methods Critically ill patients who received mechanical ventilation treatment in the Department of Intensive Care Medicine of a tertiary-level A hospital from July 2023 to February 2024 were selected as the study subjects using quasi-experiment research method，and were divided into 54 cases in the experimental group and 56 cases in the control group according to the sequence of admission time. The experimental group implemented the multidisciplinary cooperation mode of early activity based on the interprofessional collaborative team development theory，and the control group implemented the routine early activity program. The differences between the groups before and after intervention were compared in the level of cooperation of multidisciplinary team members，the rate of early activity among patients，the cumulative activity duration during ICU，the incidence of adverse events，the time of first active activity，the rate of out-of-bed activity，and the length of mechanical ventilation. Results The team cooperation level of multi-disciplinary members in experimental group was improved from（3.32±0.71） points to（3.72±0.50） points（P<0.01）. The early activity rate of experimental group was increased （The rates in experimental and control group were 48.21% and 35.22%）（P<0.05）The out-of-bed activity rate of experimental group was increased（The rates in experimental and control group were 48.1% and 7.1%）（P<0.01）. The cumulative activity time of patients during ICU stay was increased（P<0.05），and the length of mechanical ventilation was shortened（P<0.05）. There were no significant adverse events between the two groups during the activity period，and there was no significant difference in the time of the first active activity（P>0.05）. Conclusion The multidisciplinary collaboration model of early activity based on the theory of interprofessional collaborative team development may improve the cooperation level of multidisciplinary team members，promote the early activity of mechanical ventilation patients，and improve the efficiency of activity.

Objective To construct a prevention and management scheme of unexpected interruption of continuous renal replacement therapy with regional citrate anticoagulation（RCA-CRRT） in ICU patients，and to provide a theoretical basis for reducing the probability of unexpected interruption and improving the efficiency of continuous replacement therapy. Methods Based on fault tree theory，a prevention and management scheme of unexpected interruption of RCA-CRRT in ICU patients was drafted through literature review. Then the expert correspondence questionnaire was prepared，and the Delphi method was used to conduct expert consultation. Combined with the coefficient of variation，average score and expert opinion of the items，the contents of the scheme were amended and screened，forming the final scheme. Results Twenty experts were selected for two rounds of letter consultation. The final effective recovery rates of both rounds were 100%，the expert authority coefficient was 0.943 and 0.958，and the Kendall’s W was 0.224 and 0.229，respectively. The prevention and management scheme for unexpected interruption of RCA-CRRT in ICU patients was finally formed，including 5 first-level items（individual patient level，CRRT treatment level，catheter function level，quality control level，instrument and equipment level），15 second-level items and 60 third-level items. Conclusion The scheme which constructs from five levels provides a basis for the standardization of the management of RCA-CRRT，helps to further improve the use efficiency of extracorporeal circulation filter，optimize the allocation of medical resources and improve the therapeutic effect.

Objective To develop and validate a risk prediction model for venous thromboembolism（VTE） in patients with intracerebral hemorrhage（ICH） and compare its predictive ability with Caprini score. Methods The modeling group retrospectively selected ICH patients from the Medical Information Mart for Intensive Care-IV （MIMIC-IV） database（2008—2019）. Risk factors were identified using univariate and logistic regression analyses，and a risk prediction model was established. Internal validation was conducted using the bootstrap resampling method. The validation group retrospectively selected ICH patients in a tertiary hospital in China from 2016 to 2024 for external validation and compared it with the Caprini score. Results ICU length of stay（OR=1.064），absolute lymphocyte count（OR=0.711），and BMI（OR=1.932） were identified as the three independent risk factors for VTE in ICH patients. In the modeling group，the model demonstrated an AUC of 0.767，with a sensitivity of 0.718 and specificity of 0.684. The Hosmer-Lemeshow test indicated good calibration（χ²=3.075，P= 0.930）. In the external validation group，the model achieved an AUC of 0.785，AUC of the Caprini score was 0.608. Conclusion This prediction model has good predictive performance and can provide theoretical basis for clinical medical staff to early identify high-risk VTE populations in ICH patients.

This article systematically analyzes the six core challenges in the ethical review of clinical nursing research in medical institutions：weak ethical awareness among nursing researchers，lack of ethical considerations in project design，insufficient protection of the rights and interests of research participants，incomplete privacy protection mechanisms，lack of ability to identify conflicts of interest，and blurred ethical boundaries of emerging technologies. A targeted “four-dimensional improvement” strategy is proposed，and a four party linkage mechanism of “nursing management-research management-clinical research/quality promotion center-ethics committee” is constructed to implement dynamic risk assessment and process supervision. Through the above practical strategies，it is expected to enhance the ethical review in nursing research，establish an ethical management system covering the entire chain，provide evidence-based basis for the formation of the “Guidelines for Ethical Review of Nursing Clinical Research”，improve the ethical level of nursing research，and perfect the ethical governance system of nursing research in China.

Objective To establish a digital management program for acute open wounds and explore its application effects. Methods Through literature review，focus group interviews and expert meeting verification，a digital management program for acute open wounds was constructed. By convenience sampling method，131 patients admitted to the emergency department of a tertiary class A hospital in Zhejiang Province from June to December 2023 were taken as the experimental group，and were given digital management program in addition to the routine care. 134 patients admitted from June to December 2024 were taken as the control group，and were received routine care for acute open wounds. The exposure frequency of wounds，the amount of bleeding from wounds，the pain scores，and the satisfaction of doctors were compared between the two groups. Results There was no dropouts in either group. The pain score，the number of wound exposures，and the amount of wound bleeding in the experimental group were lower than those in the control group，and the differences were statistically significant（P<0.05）. The satisfaction of doctors with wound management in the experimental group was higher than that in the control group，and the difference was statistically significant（P<0.05）. Conclusion The digital management program for acute open wounds constructed in this study is scientific and feasible. Implementing this strategy can reduce the number of emergency wound exposures and the amount of bleeding，alleviate patients’ pain，and improve the satisfaction of surgeons.

Objective To develop an evaluation index system of treatment timeliness quality for emergency severe trauma patients and to evaluate its effectiveness. Methods Based on three-dimensional quality structure model，the literature search，group discussion，Delphi method and analytic hierarchy process were used to determine the contents and weight of evaluation index system. Patients with severe trauma admitted to the emergency rescue room of a tertiary grade A hospital in Nantong City from March to May 2024 were selected as the control group，patients from June to August were in the experimental group. Both groups of patients followed the established rescue process for severe trauma patients in our hospital for nursing care. The quality control in the experimental group was implemented by the quality control standards and checklists based on the constructed evaluation indicators for emergency treatment of severe trauma patients. The implementation status of indicators by nurses were compared between the two groups. Results The evaluation index system included 3 first-level indexes，13 second-level indexes and 40 third-level indexes. Effective recovery rates of two rounds of expert consultation were 86.67% and 100%，expert authority coefficients were 0.800 and 0.840 respectively，coefficients of concordance were 0.284 and 0.321，the coefficients of variation for each item in the 2nd round of correspondence were 0.01~0.21. After the implementation of evaluation indicators，significant improvements were observed in compliance rates for blood type and CBC sample delivery within 10 minutes，blood transfusion completion within 30 minutes，and CT scan completion within 30 minutes，with statistically significant differences（P<0.05）. Additionally，nurses demonstrated marked improvement in completing initial pain assessments and body temperature monitoring（P<0.05）. However，most indicators did not demonstrate a sustained significant improvement trend in subsequent dynamic evaluations. Conclusion The constructed evaluation indicators of treatment timeliness quality for emergency severe trauma patients is scientific，reliable and comprehensive，which can provide reference for implementing standardized and detailed nursing care for acute severe trauma patients.

Objective To explore the independent risk factors for deep vein thrombosis（DVT） in patients with multiple injuries，develop a risk prediction model for DVT and evaluate the effect. Methods By retrospective analysis method，425 multiple trauma patients from a tertiary hospital trauma center in Beijing from 2022 to 2023 were collected，and the patients were divided into DVT and non-DVT groups according to ultrasound results，and the variables were screened by univariate and binary logistic regression analysis. An visualized nomogram was constructed by R software，and the Bootstrap method was applied for the internal validation and model adjustment. Results The incidence of DVT in patients with multiple injuries in this study was as high as 26.82%. Logistic regression analysis showed that age，combined pelvic and acetabular fracture，combined lower extremity fracture，blood transfusion，and fibrinogen degradation products（FDP）>5 ug/ml within 24~48 h of admission were the independent risk factors for the occurrence of DVT. A risk prediction model for DVT in patients with multiple trauma was constructed and evaluated based on the above five factors，which predicted DVT with an AUC of 0.777，a Brier score of 0.049，a sensitivity of 0.728，and a specificity of 0.704. In the validation set，the AUC for predicting DVT was 0.749，the Brier score was0.070，the sensitivity was 0.553，and specificity was 0.826. Conclusion The model constructed in this study provides a simple method to calculate the DVT risk of patients with multiple trauma，and the indicators can be automatically extracted through the information system，providing a reference for early clinical screening of high-risk DVT patients with multiple trauma.

Objective To conduct a scoping review of studies on the triage standards for elderly trauma patients，to summarize and analyze the content，accuracy and related clinical outcomes of triage standards. Methods PubMed，Web of Science，Embase，CINAHL，Cochrane Library，CBM，CNKI，Wanfang，and VIP databases were searched up to November 30，2024. Studies reporting elderly-specific triage standards were screened. Data regarding the content，accuracy and related clinical outcomes were extracted. Results Fourteen articles were included. Most standards involved physiological indicators，mechanisms of injury，and anatomical considerations，with adjustments to conventional adult criteria. Eight studies elevated thresholds for systolic blood pressure and Glasgow Coma Scale scores. Three studies modified injury mechanisms and anatomical indicators. Two studies included anticoagulant/antiplatelet use and ≥2 comorbidities. Sensitivity ranged from 23.5% to 93%，and specificity from 41.5% to 95.7%. No studies directly evaluated the impact of triage standards on clinical outcomes. Conclusion Existing triage standards for elderly trauma patients vary widely in content and require improvement in accuracy. The effect of such standards on patient outcomes remains uncertain. In the future，we should develop more precise triage criteria for elderly trauma，evaluate its clinical application value，and provide basis for optimizing the treatment strategies of elderly trauma patients and improving the clinical outcomes of patients.

Objective To conduct a scoping review of the factors influencing hypothermia in trauma patients，monitoring tools，monitoring frequency，and temperature management strategies，aiming to provide references for optimizing temperature management in trauma patients. Methods Following the 2020 scoping review framework of the Joanna Briggs Institute（JBI），systematic searches were conducted in PubMed，Web of Science，Embase，Cochrane Library，CINAHL，CNKI，Wanfang and VIP，covering the period from January 1，2016，to December 27，2024. After literature screening，the factors influencing hypothermia，temperature monitoring tools，monitoring frequency，and temperature management strategies in trauma patients were summarized. Results A total of 16 articles were included for analysis. Common influencing factors included the severity of trauma，wet clothing，ambient temperature，and patient positioning. Ear temperature measurement was the most frequently mentioned monitoring method，with measurement frequency varying from continuous monitoring to every 2 hours. Rewarming methods were categorized into external and internal rewarming. Conclusion Various temperature monitoring tools，monitoring frequencies，and management strategies exist for trauma patients. Future research should focus on determining the optimal monitoring tools，frequencies，and management strategies for different trauma mechanisms in multi-center，large-sample studies.

As secondary triage constitutes a critical component in the management of mass burn casualties. Efficient secondary triage can maximize life-saving potential，improve prognosis，and ensure stable operation of healthcare systems during mass critical burn casualty management. This article will provide a review from four aspects：an overview of secondary triage for mass critically burned patients，a specialty-led multidisciplinary secondary triage collaboration model，an injury assessment method based on mortality and burn prognosis risk，and a secondary triage decision-making process driven by a multi-dimensional theoretical framework. Future research should focus on establishing standardized treatment protocols and guideline systems that are compatible with China’s national conditions and clinical practice.

To summarize the pulmonary rehabilitation nursing experience of a patient with extremely severe obesity and pulmonary embolism. The patient presented with multiple challenges，including extreme obesity，rapid disease progression，and difficulties with endotracheal intubation and extubation. A comprehensive approach was adopted to address these issues，which included the establishment of a multidisciplinary team，active management of the underlying disease，progressive resistance training，a personalized nutritional plan，and continuous psychological support. On day 18，the patient successfully underwent extubation，having lost 30 kg during hospitalization. The patient’s nutritional status was well-maintained，and improvements in physical endurance were noted. The patient was discharged on day 31 following recovery，and the follow-up of two months confirmed satisfactory recovery.

To summarize the early identification and perioperative nursing experience of 15 patients with peritoneal dialysis complicated with pleuroperitoneal communication undergoing diaphragmatic repair. For peritoneal dialysis patients，the occurrence of pleuroperitoneal communication is easily overlooked，and improper postoperative nursing can lead to recurrence，atelectasis，and other issues. To address these issues，preoperative precise stratified management and early identification of pleuroperitoneal communication was taken，and perioperative nursing plan was developed by multidisciplinary cooperation. After operation，the nursing measures such as small dose progressive dialysis program，closed thoracic drainage and seven-step functional exercise coordinated lung rehabilitation were implemented. After careful treatment and nursing，15 patients recovered and were discharged. During the follow-up of 3 to 48 months，15 patients didn’t have pleuroperitoneal communication again，and they were treated with peritoneal dialysis regularly.

To summarize the nursing experience of one case of hypertriglyceridemia induced severe acute pancreatitis patient who underwent continuous renal replacement therapy combined with hemosorption. Nursing points included medical and nursing integration to ensure the smooth implementation of combined treatment；implementation and monitoring of plasma replacement sequential plasma adsorption，prevention of rupture of membranes during plasma replacement，effective connection to ensure the implementation of sequential plasma adsorption；haemodialysis combined with hemoperfusion to reduce lipid rebound while preventing the occurrence of hypotension，and strict volume management to protect the vital organ function. After 14 d of treatment and care，the patient was successfully discharged from the hospital.

This paper summarized the postoperative nursing experience of a child with short bowel syndrome caused by a giant mesenteric lymphangioma who underwent small bowel transplantation. After the operation，on the basis of stabilizing perfusion in the early stage and preventing the risks of thrombosis and bleeding，aiming at the core difficulties such as infection prevention and control，monitoring of acute rejection reactions，management of the transplanted intestinal stoma，and nutritional support，the nursing team implemented “triple barrier” measures for infection prevention and control，the management of anti-rejection drug administration with the principle of “three fixation and one monitoring”，individualized nursing for child’s stoma，and a step-by-step nutritional support plan. The “five-in-one” integrated intervention strategy was adopted to prevent the pediatric post intensive care syndrome（PICS-p）. The child was successfully transferred out of the pediatric intensive care unit on the 28th day after the operation. After 5 months of follow-up，the child’s body weight increased by 25%，and the function of the transplanted intestine recovered well.

Objective To explore the effect of preventive contact isolation cluster measures on the prevention of multidrug-resistant organisms in ICU patients，based on the propensity score matching method（PSM）. Methods 660 adult patients were collected. According to the implementation of preventive contact isolation cluster measures，they were divided into implementation group and non-implementation group. 177 cases were in the implementation group and 483 cases were in the non-implementation group. The patients in the two groups were matched 1 ∶ 1 by the propensity score matching method. Matching variables were those that showed statistical differences in univariate analysis and common influencing factors between the two groups，including admission route，history of surgery，APACHE Ⅱ score，septic shock，use of hormones or immunosuppressants，C-reactive protein and the length of stay in ICU. After final matching，107 patients were included in each group，and the occurrence of nosocomial infection and multidrug-resistant organisms infection between the two groups were compared. Results There were no significant differences in baseline data，APACHE Ⅱ score and other risk factors between the two groups after PSM （P>0.05）. The incidence of nosocomial infection in the implementation group was slightly lower than that in the non-implementation group，and the difference was statistically significant（P<0.05），but there was no statistically significant difference in the incidence of multidrug-resistant organisms between the two groups（P>0.05）. Conclusion The implementation of preventive contact isolation cluster measures for high-risk patients has a certain effect on reducing the nosocomial infection rate in ICU，but the incidence of multidrug-resistant organisms has not been significantly reduced. In the future，it is hoped that empirical isolation will be transformed into the scientific and accurate screening of risk patients，and standardized intervention programs will be formulated and implemented.

Objective To survey the current status of ICU nurses’ competency in delirium care，and to analyze and explore the influencing factors of ICU nurses’ delirium care competency. Methods A convenience sampling method was used to select ICU nurses from five general hospitals in Zhejiang Province from January to May 2024 as the study subjects. A cross-sectional survey was conducted using the general information questionnaire and the Chinese version of the Nurse Delirium Competence Care Scale as research tools. The current status of nurses’ delirium care competency was analyzed，and univariate analysis and multiple linear regression analysis were used to explore the related factors influencing nurses’ delirium care competency. Results The total score of nurses’ delirium care competency was（88.41 ± 15.11）. Among the dimensions，the scores for items in the management process dimension were the lowest at（3.15 ± 0.75），while the scores for items in the prevention dimension were the highest at（3.35 ± 0.62）. The analysis of influencing factors showed that the degree of hospital，whether the nurse was a specialist nurse，and whether the nurse had participated in delirium-related training were independent influencing factors of nurses’ delirium care competency（P<0.05）. Conclusion The overall level of delirium care competency among ICU nurses is relatively high，but there is still room for improvement in the management process dimension. The degree of hospital，whether the nurse is a specialist nurse，and whether the nurse has participated in delirium-related training are the main factors influencing nurses’ delirium care competency. Different dimensions are affected by different factors，and targeted improvement strategies should be adopted.

Objective To Integrate Kolb’s experiential learning theory with integrated teaching in critical nursing education for master of nursing specialist（MNS） students，conduct an exploratory and small sample pilot study to verify the short-term effectiveness and operability of the teaching program. Methods Using the nominal group technique，a framework for an integrated clinical teaching program of critical care based on Kolb’s experiential learning theory was developed，four learning phases included experiential perception，reflective observation，abstract conceptualization，and active experimentation. Experts in nursing postgraduate education，critical care clinical nursing teaching and clinical nursing were invited to conduct 2 rounds of Delphi expert consultation for constructing integrated training contents covering five critical care modules. The teaching program was applied in the training of critical care nursing skills for 18 MNS students. Mini-clinical Evaluation Exercise（Mini-CEX），Learning Motivation Assessment Scale，and Satisfaction Questionnaire were used to assess the short-term effectiveness and feasibility. Results The Mini-CEX score for MNS students before training was （3.17±0.65） points，and the Learning Motivation Assessment Scale score was（120.61±17.10） points. After the training，the Mini-CEX score was（6.00±0.55） points，and the Learning Motivation Assessment Scale score was （139.22±7.10） points. The differences in scores before and after the training were statistically significant （both P<0.01）. The overall satisfaction rate of MNS students with this teaching program was 96.67%. Conclusion The integrated critical care nursing teaching program，guided by Kolb’s experiential learning theory，demonstrates scientific rigor and feasibility. It effectively enhances MNS students’ self-directed learning abilities，and help train their critical care specialty skills.

Objective To summarize the best evidence of the assessment and nursing care for chemotherapy-induced peripheral neuropathy（CIPN），so as to provide a reference for clinical practice. Methods The literature related to CIPN was systematically searched in domestic and foreign databases. The time limit for the literature search was from the January 1，2020 to December 31，2024. Results 20 pieces of literature were ultimately included，including 1 clinical decisional support，2 guidelines，5 expert consensuses，1 evidence summary，and 11 systematic reviews. Totally 22 pieces of evidence related to the assessment and nursing care for CIPN were summarized，including 6 topics：multidisciplinary collaboration，assessment of timing and content，prevention，medical-based intervention，non-pharmacological prevention，and health guidance. Conclusion It is recommended that when applying the evidence，healthcare professionals should adequately assess the risk of CIPN in patients according to their general condition，disease type，and chemotherapy regimen，take the correct preventive measures according to the type of chemotherapeutic agents，then formulate a suitable functional exercise program in combination with the patient’s physical condition，gait，and personal preference，and implement individualized lifestyle guidance.

Objective To analyze the research hotspots and development trends of literature in the field of critical care. Methods With the core database of Web of science as the data source，the critical nursing care research literature collected from January 1，2020 to December 31，2024 were retrieved. CiteSpace software was used to analyze. Results 4 288 articles were included，and the number of published articles showed an increasing trend. High-frequency keywords included “palliative care”，“mechanical ventilation”，etc. A total of 14 cluster tags such as palliative care and 25 emergent words such as early ambulation were generated. The hot topics of research involved palliative care，moral distress，prone position，mechanical ventilation，post-intensive care syndrome and so on. The research trends included the diversification of search contents of hospice care in the field of critical care，the vertical development from basic nursing quality to critical care specialization and the integration of data empowerment and emerging technologies to promote the intelligent transformation of critical care. Conclusion From 2020 to 2024，the research in the field of critical nursing care has been rising，and the research scope has been expanding，involving humanistic care，mental health promotion，quality improvement of critical care technology，rehabilitation care，intelligent care and so on. In the future，it is still necessary to strengthen multidisciplinary cooperation，actively explore and summarize the hotspots in the field of critical nursing care，and provide basis for promoting the depth and breadth of research in the field of critical nursing care.

Objective To analyze relevant studies on the use of peripherally inserted central catheters（PICC） for monitoring central venous pressure（CVP），and to clarify the feasibility，accuracy，material selection，measurement methods，and precautions for monitoring CVP via PICC，providing reference for clinical practice. Methods A computer search was conducted across PubMed，Cochrane Library，Web of Science，MEDLINE，CNKI，VIP，and Wanfang Data for literature published from the inception of the databases until 2024，regarding PICC for CVP monitoring. The selected articles were summarized. Results A total of 21 studies were included，of which 19 were randomized controlled trials（RCTs） and 2 were meta-analyses. Most studies compared CVP results measured through PICC and through central venous catheter（CVC），and there was high consistency between the two. The main factors influencing the measurement of CVP by PICC included the change of thoracic pressure，patency of catheter，the inherent resistance of catheter，the position of catheter tip，and the type of catheter front opening. Conclusion The CVP values measured via PICC are consistent with those measured using CVC. PICC can be used to measure CVP when CVC placement is not feasible due to time constraints or patient-related reasons. However，attention should be given to catheter selection and the avoidance of factors that could lead to measurement errors during the process.

Early neurological deterioration is the manifestation of the progression of acute ischemic stroke. There are many risk factors，which seriously affect the prognosis of patients. In this paper，the research reviewed the progress of risk prediction models for early neurological deterioration after non reperfusion therapy and reperfusion therapy in patients with acute ischemic stroke，summarized the aspects of model construction methods，basic conditions，predictive performance and predictive factors，so as to provide references for the construction and application of risk prediction models for early neurological deterioration in patients with acute ischemic stroke.

The health-related quality of life（HRQoL） of pregnant women with heart disease is at a relatively poor level. Accurate assessment of HRQoL in these patients is crucial for formulating individualized intervention strategies，optimizing clinical management processes，and improving maternal and infant outcomes. This article reviews the current status of HRQoL in pregnant women with heart disease，influencing factors，scales，and clinical application status. Currently，specific HRQoL scales for pregnant women with heart disease are still in their infancy，and further development and application are needed in the future.