Objective To explore the design principle and key technology of an innovative intelligent supplement device for liquid infiltration，and to realize its application in traditional Chinese medicine Tazi technique for the intervention of high fever symptoms in patients with sepsis. Methods The intelligent supplement device of liquid medicine infiltration is composed of main body，catheter，water pump，temperature and humidity probe and control unit. From March to August 2023，90 sepsis patients with high fever symptoms who were treated with traditional Chinese medicine Tazi technique in ICU of a tertiary hospital in Beijing were selected as the application objects. By random number table method，they were divided into experimental group and control group，45 cases in each group. The experimental group was treated with liquid infiltration intelligent supplement device combined with traditional Chinese medicine Tazi cooling，the control group was cooled by traditional Chinese medicine Tazi technique. The changes of body temperature were compared. Results There was a statistically significant difference in body temperature 30 min and 3 h after the end of the treatment（P<0.001）. The incidence of complications of traditional Chinese medicine was compared，and the difference was statistically significant（P<0.05）. There was a statistically significant difference in the satisfaction of patients and nurses with traditional Chinese medicine Tazi technique（P<0.001）. Conclusion The application of liquid infiltration intelligent supplement device in traditional Chinese medicine Tazi technique can quickly and continuously cool down effectively，improve the treatment effect and safety，reduce the nursing intensity，improve the compliance and satisfaction of patients with traditional Chinese medicine Tazi technique，and standardize the operation of traditional Chinese medicine Tazi technology in clinical application.

Objective To review the current status of clinical application of evidence-based prevention and management of enteral nutrition-related vomiting in mechanically ventilated patients，analyze the barriers and facilitating factors，and establish reform strategies to provide a reference for the clinical transformation of evidence. Methods Audit indicators were developed and audit methods were defined through the 26 best pieces of evidence summarized in the previous stage. The consolidated framework for implementation research（CFIR） was applied to conduct an analysis of the barriers and facilitators of the audit results from five dimensions：innovation，external factors，internal factors，individual characteristics，and the implementation process，and to formulate reform strategies. Results A total of 31 audit indicators were formulated. Among them，the implementation rate of 15 indicators was less than 60%，and the implementation rate of 4 indicators was 0. The main barriers were the lack of knowledge and training of RICU nurses in enteral nutrition management，fragmented processes，the lack of equipment and intelligent technology，insufficient multidisciplinary collaboration，and the subjective biases of medical staff. The main facilitators were the relatively good evidence transformation ability of the team，strong organizational leadership，the high enthusiasm of medical staff for reform，and the potential for multidisciplinary collaboration. Based on this，corresponding reform strategies were formulated，including carrying out stratified training and performance incentives，perfecting the processes and institutionalization，establishing multidisciplinary team collaboration and integrating intelligent tools，deploying dynamic quality control feedback mechanisms，encouraging medical staff to put forward improvement suggestions and continuously optimizing the processes. Conclusion There is a gap between the evidence and clinical practice regarding the prevention and management of enteral nutrition-related vomiting in mechanically ventilated patients. It is necessary to scientifically and comprehensively analyze the barriers and promoting factors，formulate targeted improvement strategies and action plans，and promote the clinical transformation of evidence.

Objective To investigate the effect of peripheral perfusion index combined with sequential organ failure score in predicting acute skin failure in ICU patients. Methods A total of 217 patients admitted to the ICU of a grade-Ⅲ Class A general hospital in Shandong Province from March 2023 to September 2023 were selected by convenience sampling method as the study objects. According to whether they had acute skin failure，they were divided into skin failure group（n=50） and non-skin failure group（n=167）.By comparing the data of the two groups，the area under receiver operating characteristic（ROC） curve was used to analyze the predictive value of peripheral perfusion index combined with sequential organ failure score in acute skin failure. Results Pearson correlation analysis showed that there was a significant negative correlation between peripheral perfusion index and sequential organ failure score（r=-0.589，P<0.05）. The area under ROC curve of peripheral perfusion index combined with sequential organ failure score was 0.948，sensitivity was 0.898，and specificity was 0.905. The Jorden index was 0.803. Conclusion The combination of peripheral perfusion index and sequential organ failure score can effectively predict the occurrence of acute skin failure in ICU patients，which can provide reference for clinical staff to monitor and intervene early in ICU patients with skin failure.

Objective To integrate the best evidence for the assessment and management of gastric retention in premature infants and apply it in clinical practice，and evaluate the application effects. Methods The best evidence for the assessment and management of gastric retention in premature infants was integrated. After baseline audits，analysis of barriers and facilitators，an optimal evidence-based practice protocol was developed and implemented in the Neonatal Intensive Care Unit（NICU） of a tertiary hospital from September to December 2023. Healthcare professionals’ cognitive levels，the implementation rates of audit indicators and the clinical outcomes of the infants were compared before and after the application of the evidence. Results Ultimately，10 pieces of best evidence were included. After the application of the evidence，nurses’ awareness of the evidence for assessing and managing gastric retention in premature infants increased，with cognitive levels for each indicator exceeding 80%. Healthcare professionals’ compliance with evidence-based practice behaviors improved，with implementation rates for each indicator exceeding 75%. The duration of parenteral nutrition in premature infants was shortened（P<0.05）. Conclusion The development and application of the best evidence for the assessment and management of gastric retention in premature infants improved healthcare professionals’ knowledge and standardized practice behaviors，which was beneficial for improving patient outcomes.

Objective To construct a secondary ectopic management program for PICC and to evaluate its application effects in very low birth weight infants. Methods A systematic search and quality evaluation of the evidence related to secondary ectopia of PICC in very low birth weight infants were conducted，and the first draft of the protocol was prepared. From May to June 2024，the Delphi method was used to conduct two rounds of expert consultation with 15 experts to determine the final program. Very low birth weight infants with PICC catheters inserted through the upper limbs who were admitted to the neonatal intensive care unit of a tertiary hospital in Henan Province from July to October 2024 were selected as the study subjects. The children enrolled form July to August 2024 were the control group，and the children enrolled from September to October 2024 were the observation group. The control group was treated with routine screening and nursing，and the observation group was given a management program for PICC secondary ectopic with ultrasound combined with arthroprotractor as the intervention method，and its application effect in the management of PICC in very low birth weight infants was evaluated. Results The questionnaire recovery rates were 88.24% and 100%，respectively，and the expert authority coefficient was 0.91. The final intervention program comprised eight intervention timing and six aspects of intervention content. The incidence of secondary ectopia of PICC in the control group was 39.47%，and the extubation rate of secondary ectopia PICC was 18.42%. The incidence of secondary ectopia of PICC in the observation group was 17.07%，and the extubation rate was 2.44%. The differences between the two groups were statistically significant（P<0.05）. Conclusion The application of PICC secondary ectopic management program can reduce the incidence and extubation rate of PICC secondary ectopia in very low birth weight infants，and provide a reference for the clinical management of PICC secondary ectopia.

Objective To investigate incidence of enteral nutrition feeding intolerance（FI） in pediatric patients receiving non-invasive ventilation in the neonatal intensive care unit（NICU） and analyze influencing factors for FI，for providing reference for preventing FI. Methods 172 pediatric patients receiving non-invasive ventilation in NICU in a class A tertiary hospital in Urumqi from January 2022 to March 2024 were collected as research subjects. Clinical data of the research subjects were investigated through medical record system and their clinical data were retrospectively analyzed. Incidence of FI was observed. Those pediatric patients were divided into FI group and non-FI group based on whether FI occurred and clinical data were compared between the two groups. Logistic regression was used to analyze influencing factors of FI. Receiver operating curve（ROC） was drawn to evaluate prediction value of Logistic regression model for FI. Results Among 172 pediatric patients，37.2% experienced FI. The proportion of premature infants，proportion of neonatal respiratory distress syndrome（NRDS），Acute Physiological and Chronic Health Ⅱ（APACHE Ⅱ） score，time to first enteral nutrition，nasal intermittent positive pressure ventilation，intra-abdominal pressure and proportion of use of sedatives in the FI group were higher than those in the non-FI group（P<0.05）. Logistic regression showed that premature infants（OR=5.516），NRDS（OR=4.242），APACHE Ⅱ score（OR=1.797），time to first enteral nutrition（OR=1.163），nasal intermittent positive pressure ventilation（OR=4.029），intra-abdominal pressure（OR=2.017） and use of sedatives（OR=4.247） were all independent risk factors for FI in NICU patients receiving non-invasive ventilation（P<0.05）. ROC analysis showed that the area under the curve（AUC） of the Logistic regression model was 0.974，with a sensitivity of 96.9% and a specificity of 91.7%，indicating good predictive performance. Conclusion Pediatric patients receiving non-invasive ventilation in NICU have a high incidence of enteral nutrition FI. Premature infants，NRDS，APACHE Ⅱ score，first enteral nutrition，nasal intermittent positive pressure ventilation，intra-abdominal pressure and use of sedatives are risk factors for FI. For pediatric patients with the above-mentioned FI risk factors，they should be intervened early. And we should start enteral nutrition support as early as possible，choose an appropriate ventilation mode and try to avoid and reduce the use of sedatives.

Objective To explore and analyze the core competence elements of palliative care among nurses in neonatal intensive care unit（NICU），aiming to provide a valuable reference for nursing administrators to conduct education and training in palliative care. Methods A qualitative research method was adopted，involving semi-structured interviews with a total of 15 medical staff，social workers，and volunteers from three tertiary class A children’s hospitals in Zhejiang，Jiangsu，and Hunan provinces from February to May 2024. The interview contents were sorted out and analyzed by using Colaizzi’s method. Results The core competence of NICU nurses in palliative care could be summarized into 7 themes：comprehensive assessment ability，symptom management ability，psycho-spiritual support ability，social support ability，communication and cooperation ability，self-regulation and self-learning ability，and moral and ethical adherence. Conclusion NICU nurses should have various abilities when providing palliative care. Comprehensive assessment ability is the prerequisite for implementing palliative care，symptom management ability is the core of improving the quality of life for terminally ill newborns，psycho-spiritual support ability and social support ability are crucial for offering bereavement support to bereaved families，communication and cooperation ability is the method to solve the problems for terminally ill newborns and their families，self-regulation and self-learning ability is fundamental to maintaining self emotional stability，and moral and ethical adherence is the basis for handling conflicts.

Objective To develop and validate a scale for assessing the perceived nursing care needs of parents of neonates in the neonatal intensive care unit（NICU）. Methods An initial draft of the scale was constructed through literature review，semi-structured interviews，and brainstorming techniques. After two rounds of Delphi expert consultation，a pilot version was finalized. From April to November 2024，convenience sampling was used to survey 367 parents of NICU patients across three tertiary Grade-A hospitals in Anhui Province to evaluate the scale’s reliability and validity. Results The Perceived Nursing Needs Scale for Parents of Neonates in NICU included four dimensions：perceived effective communication，perceived psychological support，perceived extended care，and perceived professional competence，with a total of 32 items. The overall Cronbach’s α coefficient of the scale was 0.948，the split-half reliability was 0.850，and the test-retest reliability was 0.879，the content validity index reached 0.875. Exploratory factor analysis extracted four principal factors with strong construct validity，accounting for 63.438% of the total variance. Confirmatory factor analysis showed that composite reliability （CR） of each dimension ranging from 0.898 to 0.933，average variance extracted（AVE） from 0.542 to 0.604，and AVE square roots between 0.736 and 0.777，indicating stable factor structure of the scale. Conclusion The Perceived Nursing Needs Scale for Parents of Neonates in NICU has good reliability and validity，which can be used to assess the actual nursing care needs perceived by parents of NICU neonates.

With the increasingly widespread application of Internet technology in nursing research，including digital literature retrieval and scientific data sharing，online surveys have emerged as a predominant trend，gradually replacing traditional paper-based methods. Online surveys utilizing the checklist for reporting results of internet e-surveys（CHERRIES） offer a standardized framework for related research，boasting advantages such as rapid data collection，automated data entry，and reduced potential for human error，thereby facilitating the acquisition of high-quality results. This paper provides an in-depth interpretation and analysis of the eight sections and 30 items outlined in the CHERRIES checklist，aiming to establish a foundation for more systematic and standardized online survey research in China.

To summarize the nursing experience of a patient with exertional heat stroke induced by a marathon race and complicated with multiple organ failure，as well as invasive aspergillosis infection on the posterior lateral side of the right elbow. To address complex issues such as multiple organ failure，severe infections，nutritional and metabolic abnormalities，and psychological adaptation disorders in the patient，measures such as dynamic monitoring of pressure values such as arterial pressure，venous pressure，and transmembrane pressure，as well as local anticoagulation in vitro，were taken to maintain life support and protect liver and kidney function. We chose appropriate incision dressings，controlled negative pressure drainage pressure，etc.，to reduce the risk of infection spread and accelerate healing. We provided refined nutritional support to meet the special nutritional needs of the body and carried out targeted psychological interventions to alleviate post-traumatic stress reactions. After 39 days of personalized treatment and care，the patient recovered and was discharged. After one week follow-up after discharge，the patient’s condition was good.

This paper summarized the nursing experience of a child with total left lung atelectasis，fibrous plaque formation，and difficulty in weaning off the ventilator，who underwent respiratory therapy nurse-led lung recruitment maneuver treatment. In response to the child’s poor chest wall elasticity and susceptibility to atelectasis complications，a dual assessment system was used before the recruitment maneuver to assess lung recruitability and establish the child’s safe recruitment threshold. A combination of deep sedation, progressive recruitment maneuvers, and individualized PEEP titration ensured safety. Following programmed weaning and respiratory training, the child was extubated and discharged on day 18, with good follow-up outcomes.

This article summarized the nursing experience of a patient with plasma cell disease who developed cytokine release syndrome（CRS） following chimeric antigen receptor T-cell（CAR-T） therapy. The patient exhibited severe clinical manifestations of CRS，including altered mental status，chills with high fever，hypotension，and pancytopenia. A comprehensive nursing approach was implemented，which included rigorous monitoring of the patient’s condition，prompt initiation of emergency response protocols，circulatory support，continuous renal replacement therapy（CRRT），and infection prevention. As a result of these measures，the patient was successfully treated and discharged. Follow-up revealed that the patient had a good quality of life.

To summarize the nursing experience of pulmonary rehabilitation in a patient with respiratory failure secondary to weaning failure of cardiac origin. In response to issues such as difficulty in weaning and heart failure，nursing points included nurse-led establishment of a multidisciplinary pulmonary rehabilitation management team，balancing respiratory support and cardiac load during the acute phase，prioritizing cardiac function improvement，and refined volume management. During the rehabilitation period，offline training with “three-stage cardiac function warning” was performed，sequential sedation and analgesia，and personalized lung rehabilitation were implemented. After careful care，the patient successfully removed the ventilator on the 48th day of admission and was transferred to a regular ward. He was discharged on the 62nd day.

To summarize the nursing experience of a child with congenital solitary functioning kidney and severe pneumonia supported by extracorporeal membrane oxygenation and prone ventilation. Key nursing interventions included multidisciplinary collaboration to achieve efficient initiation and safe out-of-hospital transport of ECMO，restrictive fluid resuscitation to optimize renal protection，prone ventilation guided by electrical impedance tomography（EIT） to support staged pulmonary rehabilitation，infection control led by liaison nurses for infection prevention and control to cut off infection source and whole process management，and family-involved multisensory care to promote psychological recovery. After 30 days of active treatment and comprehensive nursing，the patient’s organ function gradually recovered and she was successfully transferred to a local hospital for further rehabilitation.

To summarize pulmonary rehabilitation nursing for a patient with lumbar tuberculosis and complicated with cardiopulmonary dysfunction. For the patient with lumbar tuberculosis complicated by cardiopulmonary insufficiency，there were some difficulties in pulmonary rehabilitation nursing，such as restricted positioning，fluid overload，pain，sputum retention and respiratory muscle dysfunction. Interventions were taken，including optimized positioning to reduce spinal shear forces and improve ventilation，refined volume and pain management to decrease cardiovascular strain and prepare for pulmonary rehabilitation as a prerequisite，ultrasound-guided targeted airway clearance to enhance sputum removal and gas exchange；and advanced active respiratory techniques combined with axial-stabilized exercises to promote the coordinated reconstruction of respiratory and skeletal muscles. Following 17 days of specialized care，the patient successfully transitioned from ICU to continued rehabilitation.

Objective To investigate the prevalence and associated factors of workplace verbal abuse（WPVA） by patients among emergency department nurses in tertiary class A hospitals. Methods From June to July 2024，a total of 1，597 emergency department nurses from 67 tertiary class A hospitals across 15 provinces/autonomous regions/municipalities in China were recruited via convenience sampling. Data were collected using a general information questionnaire，a self-designed WPVA incidence survey，the Jefferson Scale of Empathy-health Professionals，and the Clinical Communication Competence Scale for Nursing Students. Univariate analysis and binary logistic regression were employed to identify influencing factors. Results The incidence of WPVA among emergency department nurses was 57.88%. Logistic regression revealed that nurses who were unmarried，worked a higher number of night shifts per month，were employed in hospitals with ineffective handling of previous WPVA incidents，or exhibited lower empathy and clinical communication competence faced a significantly elevated risk of experiencing WPVA. Conclusion The incidence of WPVA among emergency department nurses is relatively high. Nursing managers should pay attention to and identify the risk population of WPVA，and formulate intervention measures based on relevant factors to reduce the occurrence of WPVA among emergency department nurses.

Objective To explore the real feelings of nurses’ communication experience in pediatric emergency triage，and to provide reference for developing strategies to improve the quality of nursing communication. Methods Objective sampling method was used to conduct semi-structured interviews with 13 pediatric emergency triage nurses from a tertiary grade A children’s hospital in Southwest China in January 2024. Based on the social ecosystem theory，the interview data were analyzed by directional content analysis method. Results Three themes and nine sub-themes were extracted：micro system（communication attitude changed from positive to negative，negative feedback effect of non-verbal communication，insufficient integration of communication skills and professional know-ledge）；meso-system（difficulty to establish trust relationship，different attention of the two sides of nurse-patient com-munication，negative impact of environmental atmosphere，higher demand for team communication and collaboration）；macro system（eager to optimize the hospital treatment process，relative insufficiency of pediatric emergency informa-tion construction）. Conclusion The social ecosystem of nurse-patient communication experience of pediatric emergency triage nurses was not optimistic. Nursing managers should attach importance to the training of com-munication ability of pediatric emergency triage nurses，implement reflective practices，accelerate the construction of pediatric emergency information and other comprehensive interventions，so as to improve the nurse-patient communi-cation quality of pediatric emergency triage nurses and patient medical experience，and improve patient satisfaction.

Objective To evaluate the effectiveness of sensory stimulation on ICU patients’ consciousness levels，considering different implementers，content，frequency，and duration. Methods A systematic search was conducted in PubMed，Cochrane Library，Web of Science，Embase，CNKI，Wanfang，and VIP databases. The inclusion criteria included randomized controlled trials involving ICU patients，the intervention methods for the experimental group were sensory stimulation with different protocols，while the intervention methods for the control group were routine nursing or other programs. The primary outcome was post-intervention Glasgow Coma Scale scores. Two researchers independently screened studies，extracted data，and assessed bias. A network meta-analysis using R 4.3.2 Gemtc package and the optimal ranking probability of intervention programs was calculated by accumulating the area under the ranking curve. Results Fourteen studies were included. Sensory stimulation with direct family involvement was most effective，followed by indirect family and nurse-led interventions. Multi-sensory stimulation outperformed combined or single-sensory approaches. Twice-daily interventions were most effective，followed by three times a day and once a day. 10 days interventions were most effective，followed by>30 days，7 days，30 days and <7 days. Conclusion Based on the limited evidence，sensory stimulation improves ICU patients’ consciousness，with family involvement and multi-sensory approaches yielding the best outcomes. The intervention period should be at least 7 days to produce good results，and twice daily sensory stimulation is the optimal frequency.

Objective To comprehensively search，screen，evaluate，and summarize the best evidence of identification and nursing for emergency patients with sepsis at home and abroad. Methods The clinical decision，recommended practice，evidence summary，guidelines，systematic review，expert consensus on the early identification and nursing of emergency patients with sepsis were systematically searched in domestic and foreign databases. The search period was from January 1，2015 to January 1，2025. Results A total of 18 articles were included，including 2 clinical decisions，5 guidelines，4 evidence summaries，3 systematic reviews，and 4 expert consensuses. A total of 34 pieces of evidence from 8 aspects were summarized，including early screening and identification，cluster nursing，hemodynamic monitoring，respiratory support，sedation and analgesia，nutritional support，blood glucose management，teamwork and quality evaluation. Conclusion This study summarizes the best evidence for early identification and nursing of adult emergency patients with sepsis. It suggests that clinical nursing staff should combine the domestic evidence application situation to select and transform the evidence pertinently，implement the early identification and timely rescue of emergency patients with sepsis，to improve the clinical outcome of patients.

Objective A scoping review was conducted on the relevant content of assessment tools for cognitive function after liver transplantation in children. Methods Studies were searched from databases of PubMed，Embase，Cochrane Library，Web of Science，CINAHL，SinoMed，CNKI，WanFang，and VIP from inception to March 2025. Literature was screened and literature-related information was extracted according to the established inclusion and exclusion criteria. Results A total of 25 articles were included，with a total of 25 assessment tools and 7 types. The most commonly used were the Wechsler Preschool and Primary Intelligence Scale 3rd Edition，the Wechsler Intelligence Scale for Children 4th Edition，Beery-Buktenica Visual-Motor Integration Test，Pediatric Quality of Life Inventory^TM Cognitive Functioning Scale，Bayley scale of infant development. Conclusion There are a wide variety of cognitive function assessment tools after liver transplantation，and the reliability and validity need to be further verified. It is suggested that researchers should develop a targeted assessment scale for cognitive function after liver transplantation according to the national conditions of China and the clinical characteristics of children with liver transplantation.

Objective To conduct a scoping review about relevant research on ICU-acquired oral frailty，summarize the conceptual definitions and related elements of ICU-acquired oral frailty. Methods The methodology framework was guided by the Joanna Briggs Institute（JBI） Evidence-Based Healthcare Center’s PRISMA-ScR guidelines for scoping reviews. A comprehensive search was conducted in databases including PubMed，Embase，CINAHL，Web of Science，Scopus，China National Knowledge Infrastructure（CNKI），Wanfang Data，and the Chinese Biomedical Literature Database，covering literature from the inception of these databases to November 12，2024. Literature intersecting ICU acquired weakness and oral frailty was screened，and information was extracted. A conceptual assessment tool was employed to analyze，evaluate，and integrate the identified elements. Results A total of 14 articles were included，from which 14 relevant concepts and 94 related elements were extracted. Among the extracted concepts，none met the criteria for a “good” conceptual definition. Three categories of elements and 14 thematic elements were identified. Conclusion Conceptual research based on a scoping review confirms that ICU patients are prone to oral frailty due to special medical environments such as invasive procedures，but its definition has not yet been standardized. Existing assessment tools lack systematic standards addressing the specific needs of ICU patients. There is a need to further improve and optimize the concepts related to ICU-acquired oral frailty to enhance the quality of ICU care and improve patients’ subsequent quality of life.

Intrapartum ultrasound and postural guidance is to provide more accurate labor management for patients with abnormal fetal orientation through the combination of abdominal or perineal ultrasound and free postural position. This paper reviewed the value of intrapartum ultrasound and postural guidance in the treatment of abnormal fetal orientation，nursing intervention plan and effect evaluation，application obstacles and prospects. This review aimed to explore the potential positive effects of intrapartum ultrasound and postural guidance in the management of abnormal fetal orientation，with a view to providing more comfortable，safe and accurate examination and guidance methods for vaginal delivery patients，promoting vaginal delivery and ensuring the safety of mother and child. However，the standardization of clinical implementation needs to be further established and improved.