Objective To explore the lived experiences and needs of elderly pneumonia patients during enteral tube feeding，providing insights for optimizing comprehensive care in this population. Methods A descriptive qualitative study was conducted. Using purposive sampling，15 elderly pneumonia patients receiving enteral nutrition in the Department of Respiratory and Critical Care Medicine at Beijing Hospital from February 2025 to April 2025 were enrolled for semi-structured interviews. Thematic analysis was performed with NVivo 11.0 software. Results Interviews with 15 participants were completed. By mapping the enteral nutrition timeline as the horizontal axis and categorizing content into three dimensions（task-related，emotional，and pain points），25 themes were identified，including understanding necessity，risk perception，emotional venting，care support，and symptom management. These findings were synthesized to construct an experience journey map of enteral nutrition for elderly pneumonia patients. Conclusion The enteral nutrition support process for elderly patients with severe pneumonia is often prolonged，with a high incidence of feeding intolerance and significant individual variability. Using journey mapping，the needs of patients during tube feeding can be elaborated in detail. For instance，the lack of meticulous observation during the adjustment and optimization phase may lead to failure in early identification of enteral nutrition intolerance，thereby posing greater challenges in symptom management. To address this issue，it is essential to strengthen shift-based risk assessments and symptom monitoring to reduce the risk of worsening enteral nutrition intolerance symptoms. Furthermore，peer interaction and role dynamics directly influence patient experience，particularly highlighting the need to emphasize the quality of post-discharge care provided by family members. Additionally，exploring suitable remote continuity-of-care models for elderly patients with severe pneumonia is crucial.

Objective To investigate the clinical characteristics of patients with cardiac arrest（CA） in the emergency department and the factors influencing the return of spontaneous circulation（ROSC）. Methods A retrospective analysis was conducted on the 325 emergency CA cases who underwent cardiopulmonary resuscitation（CPR） at a tertiary hospital in Zhejiang Province from January 2021 to December 2023. The factors influencing ROSC were examined using univariate and multivariate logistic regression analyses. Results Among them，the rate of ROSC was 30.14% in patients with out-of-hospital cardiac arrest（OHCA） and 55.17% in those with in-hospital cardiac arrest（IHCA）. Furthermore，regression analysis demonstrated that，compared with patients whose in-hospital resuscitation time was less than 15 minutes，those with longer resuscitation time had a markedly lower probability of ROSC，and the difference was statistically significant（P<0.001）. Initiating ECMO（β=4.709，P<0.001，OR=110.994，95%CI：23.763-518.452） and metabolic disease（β=1.594，P=0.004，OR=4.924，95%CI：1.685-14.387） were protective factors influencing ROSC in all CA patients. Conclusion Initiation of ECMO and the presence of metabolic disorders were identified as independent protective factors for ROSC in patients with cardiac arrest，highlighting the need for reinforced blood glucose monitoring in individuals with metabolic disorders during resuscitation.

Objective To investigate the effect of flexible on-demand visiting intervention model based on the Knowledge，Attitudes and Practices（KAP） model on the occurrence of delirium in ICU patients. Methods Eighty patients treated in the ICU of the First Affiliated Hospital of Anhui Medical University during the time period of December 2024 to March 2025 were selected as the study subjects，and they were randomly divided into the control group and the experimental group，each with 40 cases. The control group implemented conventional nursing care，and the experimental group implemented the flexible on-demand visiting intervention model based on the KAP model. The ICU delirium scale（CAM-ICU-7） was used to compare the delirium levels of patients in the two groups 14day before and 3day，7day，and 14day after the intervention. And the nursing care satisfaction scores，adherence scores of the two groups were assessed and compared 14day before and after the intervention. Results After the intervention，the delirium score of patients in the experimental group was lower than that of the control group（P<0.001）. The nursing care adherence of patients in the experimental group was higher than that of the control group（P<0.05）. The delirium scores of patients in both groups decreased，and the patient satisfaction score of the experimental group was higher than that of the control group（P<0.001）. The levels of patient adherence and nursing satisfaction increased in both groups compared with the pre-intervention period. Conclusion Flexible on-demand visitation intervention based on the KAP model can reduce delirium level of ICU patients，improve treatment adherence，and thus enhance the nursing satisfaction of patients and their families.

Objective To explore the barriers to participation in advance care planning（ACP） decision-making among surrogate decision-makers in the ICU，and to provide a basis for developing decision support tools. Methods From October 2024 to December 2024，an interview guide was developed based on the Theoretical Domains Framework（TDF）. Face-to-face interviews were conducted with 18 surrogate decision-makers of ICU patients in a tertiary hospital in Nanjing. The transcribed texts were analyzed according to the relevant domains of the TDF. Results Based on the TDF，the barriers to ACP decision-making among ICU surrogate decision-makers were categorized into 5 themes and 13 sub-themes： ①Execution barriers under ambiguous patient preferences； ②Breakdown in the procedural mechanisms of ACP participation；③Constraints from sociocultural norms and public discourse； ④Blurred role recognition of the decision-making surrogate； ⑤Irrational decision-making driven by emotions. Conclusion The ACP decision-making of ICU surrogate decision-makers is influenced by multiple factors. Cognitive restructuring，improved communication，emotional support，and reconstruction of the medical-social network are needed to reduce negative experiences during the decision-making process.

Objective To identify latent types and determinants of nurse-family communication barriers in ICUs and inform targeted intervention design. Methods In June 2025，twenty nurses from a comprehensive ICU of a tertiary hospital in Guangzhou were enrolled. Using Q-methodology，we constructed the Q-set，selected the P-sample，conducted Q-sorting，and performed Q-analysis to rank and classify barriers and influencing factors. Results Seventeen nurses were included in the final analysis. Four factors were extracted，explaining 82% of the total variance，including institutional constraints（eigenvalue 9.11； 46% variance），emotional exhaustion（3.82； 19%），support deficiency（1.74； 9%），and skill dilemma（1.58； 8%）. Conclusion ICU nurses show distinct patterns of communication barriers and determinants. High workload，psychological strain，burnout，limited communication skills，and inadequate emotional support contribute to communication difficulties. Tailored strategies addressing these factors are needed to improve nurse-family communication and family satisfaction.

Objective To explore non-verbal communication needs of mechanically ventilated patients，providing reference for formulating their non-verbal communication strategies. Methods From May to December 2024，purposeful sampling was used to conduct semi-structured interviews with post-extubation mechanically ventilated patients and ICU nurses in a tertiary hospital in Zhejiang. Data were analyzed via Van Manen method. Results Non-verbal communication needs of ICU mechanically ventilated patients involved 5 themes（suitability of needs communication，prominent willingness to communicate physiological needs，limited expression of psychological needs，safety communication，care and family communication，and environmental communication are required prominent physiological needs，restricted psychological expression，safety communication，care and family communication，and environment communication） and 18 sub-themes（adaptability of communication strategies， suppression of psychological needs expression， etc.）. Conclusion The nonverbal communication needs of mechanically ventilated patients are diverse，with a strong desire for communication. Researchers should clarify their communication scope，develop effective communication strategies，accurately identify their needs，and improve their physiological and psychological satisfaction and oxygen therapy safety.

Objective To explore the application effect of goal-oriented training based on virtual reality（VR） technology in the rehabilitation of ICU patients. Methods Sixty patients admitted to the Department of Critical Care Medicine of a tertiary hospital in Zhejiang Province from July 2024 to December 2024 were selected and randomly divided into 30 cases each in the control group and the experimental group. Both groups received conventional rehabilitation treatment，and the experimental group applied the self-developed bedside VR rehabilitation system for immersive goal-oriented training on this basis. We compared the differences in muscle strength（Medical Research Council Scale，MRC） score and muscle thickness（rectus femoris） between the two groups at the time of transferring into ICU and transferring out of ICU，and compared the ICU Mobility Scale（IMS） score，lower limb stepping trainer active movement duration and grip strength before the intervention，1 week after the intervention，and 2 weeks after the intervention. Results The differences in MRC scores between the two groups were not statistically significant when the patients were transferred to the ICU（P>0.05），and the MRC scores of the experimental group were higher than those of the control group when the patients were transferred out of the ICU（P<0.05）. The differences between the two groups were not statistically significant in terms of the IMS scores，grip strength，the length of active exercise on treadmill，and the resistance before the intervention（P>0.05），and the differences of the scores in the experimental were higher than those of the control group 1 week and 2 weeks after the intervention（P<0.05）. The differences in muscle thickness between the two groups of patients at the time of transfer to and from the ICU were not statistically significant（P>0.05）. Conclusion Goal-oriented training based on VR technology can improve the muscle strength，grip strength and activity ability of ICU patients，and has a promoting effect on their recovery.

Objective To explore the current status and latent profile analysis of post-traumatic growth（PTG） in young and middle-aged patients with mechanical ventilation in Intensive Care Unit（ICU），and analyze its influencing factors，so as to provide reference for future nursing intervention programs. Methods A total of 242 young and middle-aged ICU patients with mechanical ventilation were selected by convenience sampling method. General data questionnaire and simplified Chinese version of PTG questionnaire were used for the study. Potential categories of patients’ PTG were identified based on latent profile analysis，and the influencing factors of different categories were analyzed by multiple Logistic regression. Results The PTG score of the young and middle-aged patients with mechanical ventilation in ICU was 49.18±14.05. The results of the latent profile analysis indicated that PTG could be classified into three distinct categories： high PTG-attention to change group，medium PTG-high perception group and low PTG-avoidance of change group. Gender，marital status，education level，occupation，number of chronic diseases and whether or not they were treated by operation were the influencing factors of PTG among different categories of young and middle-aged patients with mechanical ventilation in ICU （all P<0.05）. Conclusion There is heterogeneity of PTG in young and middle-aged patients with mechanical ventilation in ICU. Medical staff should identify PTG level in time and implement targeted intervention measures according to the characteristics of different categories of patients to improve PTG level and promote early recovery of patients.

This paper summarized the nursing experience of a patient with traumatic urinothorax. In response to the patient’s urinothorax，acute kidney injury，coagulation dysfunction and hypothermia，the following nursing measures were taken，including early identification of traumatic urinothorax，continuous renal replacement therapy，comprehensive intervention for traumatic coagulation disorders，meticulous temperature management，and individualized pulmonary rehabilitation strategies. After 15 days of treatment and care，the patient’s condition was stable and he was transferred to a rehabilitation hospital for further treatment.

To summarize the nursing experience of a case of mixed shock after liver transplantation for autoimmune hepatitis treated with extracorporeal membrane oxygenation. In response to problems such as severe mixed shock and critical organ hypoperfusion，the following nursing measures were implemented，including targeted circulatory resuscitation strategies，precise management of extracorporeal support and organ perfusion optimization，immunotherapy management based on therapeutic drug monitoring，and multi-dimensional barrier construction with infection prevention and control protocols. The patient was transferred to a general ward on the 29th day of hospitalization with stable condition and was discharged smoothly after 77 days of hospitalization. The patient was in good condition during the one-month follow-up after discharge.

This study aimed to summarize the nursing experience associated with high-flow nasal cannula （HFNC） oxygen therapy in home oxygen therapy for premature infants diagnosed with severe bronchopulmonary dysplasia（sBPD）. A retrospective analysis was conducted using the clinical data of six preterm infants with sBPD who received HFNC-based home oxygen therapy between January 2022 and December 2024. For preterm infants with long-term dependence on home oxygen therapy，a pre-discharge readiness assessment and caregiver empowerment education were implemented. Key interventions included proper administration of home oxygen therapy，development of discontinuation plans based on target blood oxygen saturation （SpO₂） monitoring，appropriate management of adverse events such as choking，asphyxia，and equipment malfunction，as well as structured follow-up protocols. These measures contributed to improved growth and development outcomes and enhanced family quality of life. During the HFNC home oxygen therapy period，among the six infants，only one required hospitalization twice due to milk aspiration and another was readmitted due to rhinovirus infection；the remaining infants completed therapy without complications. During the HFNC home oxygen therapy of the six infants，one infant choked twice and one was readmitted due to rhinovirus infection，while the rest of the infants received HFNC home oxygen therapy smoothly. Among the three weaned infants，one achieved direct oxygen discontinuation after 130 days of home oxygen therapy when the fraction of inspired oxygen（FiO₂） reached 25% and the oxygen flow rate was maintained at 10 L/min. The other two infants received home oxygen therapy for 268 days and 22 days，respectively，followed by a transition to low-flow nasal cannula oxygen therapy prior to successful oxygen weaning. The other three remain under scheduled follow-up.

To summarize perioperative nursing experience for a premature infant with large sacrococcygeal teratoma. Nursing points included preoperative prevention of tumor infection and psychological counseling for parents，postoperative personalized stepwise respiratory support to facilitate weaning from oxygen，standardized use of vacuum sealed drainage（VSD） technology to promote smooth removal，strengthening hospital-acquired infection control to prevent postoperative infections，precise feeding management to promote early full oral feeding，dynamic pain safety management and selecting the optimal analgesia method，and family-integrated care alongside multimodal follow-up to enhance recovery. After 44 days of precise perioperative nursing，the infant showed good wound recovery，was gradually weaned from oxygen support，and was discharged successfully.

To summarize the nursing experience of a premature infant with bronchopulmonary dysplasia and congenital pulmonary bullae at a gestational age of 23⁺¹ week with a survival limit. In response to the infant with extremely premature birth，low body weight，poor lung conditions and extremely high surgical risks，key points of nursing care included individualized airway care，avoiding unplanned extubation，formulation of the rescue process for pulmonary bullae，attaching importance to the nursing of closed thoracic drainage，dynamic monitoring of infection indicators，implementation of family integrated care and other nursing measures. The infant was discharged from the hospital smoothly after 158 days of hospitalization，with stable breathing and feeding tolerance. She has been followed up for more than 8 months. Her weight has increased to 8.9 kg and she was gradually catching up. Her general condition was good.

This paper summarized the nursing experience of a patient with acral necrosis caused by catastrophic antiphospholipid syndrome. In response to the patient’s characteristics of critical condition，rapid progression and involvement of multiple systems，measures such as multidisciplinary collaboration to deal with catastrophic antiphospholipid syndrome，balance management of thrombosis and hemorrhage，protection of multiple organ functions，and comprehensive management after amputation were adopted. The patient’s condition was effectively controlled，she was successfully transferred out of the ICU after 7 days and discharged from the hospital after 22 days of recovery. Follow-up showed that there were no complications such as hemorrhage or new thrombosis，the patient’s mental state was good，and she had started prosthetic adaptation training.

Objective To investigate the impact of a continuous quality improvement strategy based on the Analysis-Design-Development-Implementation-Evaluation（ADDIE） model on enhancing the compliance of intensive care unit（ICU） medical staff with the 1-hour bundle therapy for septic shock，and its effect on septic shock patients’ clinical outcomes. Methods This study was conducted in the ICU of a tertiary class A hospital in Hubei Province. The study population included patients diagnosed with septic shock and admitted between June 2021 and May 2024. The study adopted a continuous quality improvement design and implemented interventions based on the ADDIE model. It was divided into four phases：baseline data collection and preparation（June 2021 to May 2022），intensive training （June 2022），and two quality improvement cycles（July 2022 to May 2023 and June 2023 to May 2024）. Data were collected on ICU medical staff compliance with the 1-hour bundle，patient ICU length of stay，and in-hospital mortality. The Kruskal-Wallis H test was used to compare length of stay，and the chi-square test was used to compare compliance rates and mortality across phases. Results A total of 396 patients were included，with 87 in the baseline phase，151 in the first quality improvement cycle，and 158 in the second quality improvement cycle. Compliance with each component of the 1-hour bundle showed an overall increasing trend. Statistical analysis revealed significant improvements in all measures across the three time points，except for maintenance of mean arterial pressure≥65 mmHg（1 mmHg=0.133 kPa）（P>0.05）. The in-hospital mortality rate in the second quality improvement cycle（18.35%） was significantly lower than that in the baseline phase（28.74%）（P<0.05）. Conclusion The continuous quality improvement strategy based on the ADDIE model significantly improved compliance of ICU staff with the 1-hour bundle therapy and effectively reduced in-hospital mortality by enhancing the implementation quality of key interventions.

Objective To translate and culturally adapt the Trauma Disclosure Expectancy Scale into Chinese，and to assess the reliability and validity of the Chinese version. Methods The Chinese version of Trauma Disclosure Expectancy Scale was translated，back-translated，and culturally debugged according to the Brislin translation model. The convenience sampling method was used to select 311 car accident survivors from the emergency department，emergency wards，orthopedic department，and rehabilitation department of a tertiary level A hospital in Zhejiang Province between February and March 2025. The reliability and validity of the Chinese version were tested，with 30 patients randomly selected for test-retest reliability assessment after a 2-week interval. Results The Chinese version of the Trauma Disclosure Expectancy Scale comprised 2 dimensions and 21 items. The scale demonstrated a Cronbach’s α coefficient of 0.900 and a test-retest reliability of 0.890. The content validity index was 0.902，with item-level content validity indices ranging from 0.803 to 1.000. Exploratory factor analysis extracted 2 dimensions，accounting for 69.69% of the cumulative variance. The scale scores showed a positive correlation with the Generalized Anxiety Disorder Scale （r=0.313，P<0.001） and a negative correlation with the Posttraumatic Growth Inventory（r=-0.217，P<0.001）. Conclusion The Chinese version of the Trauma Disclosure Expectancy Scale exhibits good reliability and validity，making it suitable for assessing patients’ psychological expectations of trauma exposure. It provides a scientific foundation for post-traumatic psychological interventions and nursing practices.

Objective To evaluate the measurement performance of patient-reported outcome measures in patients with post-thrombotic syndrome and to provide a basis for the selection of clinical evaluation tools. Methods The original studies on patient-reported outcome measures for patients with post-thrombotic syndrome were searched in databases such as Embase，MEDLINE，Springer Link，Web of science，PubMed，Weipu，Wanfang，and CNKI from inception to December 2024. Two researchers independently screened the literature and extracted relevant data，and the evaluation tools were evaluated based on the consensus-based standards for the selection of health measurement instruments （COSMIN） method，and if there was a disagreement，the third researcher decided. Results A total of 10 evaluation tools was included，and all of them had different degrees of methodological problems. According to COSMIN guidelines，the VEINES-the quality of life/symptom（VEINES-QOL/Sym） and Villalta-PVR2 scales are class A assessment tools，and the rest of the scales are class B assessment tools. Conclusion The choice of assessment tools should be dependent on specific clinical circumstances and further verified in different environments and populations. It is recommended that the Villalta-PVR2 scale be prioritized for primary screening at the grassroots level，and the VEINES-QOL/Sym scale be used for specialized follow-up. In the multi-dimensional exploration of research scenarios，various assessment tools can be adopted in a collaborative manner.

Objective To retrieve，evaluate and summarize the best evidence for continuous ST-segment monitoring in patients with myocardial ischemia，so as to provide an evidence-based basis for effectively identifying and warning of changes in medical condition. Methods We searched from 12 databases，9 guideline websites or association websites for literature on continuous ST-segment monitoring，up to December 31，2024，including guidelines，expert consensus，systematic reviews，evidence summaries and practice standards. Literature related was screened，and evaluated using the corresponding quality evaluation tools，and evidence was extracted and integrated from the final included literature. Results A total of 8 articles were selected，including 5 guidelines，2 practice standards and 1 evidence summary. Finally，8 themes were formed from 44 pieces of best evidence，including developing practical standards，continuing education and training，appropriate population and monitoring duration，posture and skin preparation，electrode placement，lead selection，alarm management，and documentation. Conclusion The best evidence for continuous ST-segment monitoring in myocardial ischemia patients summarized in this study is scientific and comprehensive. It is recommended that caregivers carefully select evidence based on clinical context，to fully utilize the monitoring effectiveness of electrocardiogram monitoring.

Postoperative pulmonary complications（PPCs） in patients undergoing cardiopulmonary bypass surgery occur with high frequency，directly leading to prolonged hospitalization，increased treatment costs，and significantly impaired postoperative recovery and quality of life. Accurate assessment enables early identification and diagnosis of complications，thereby guiding the improvement of nursing strategies. This article reviews domestic and international assessment methods for PPCs in post-cardiopulmonary bypass patients and discusses key points in implementing assessment-based goal-directed nursing interventions，aiming to provide references for enhancing the evaluation and nursing quality of PPCs in ICU patients following cardiopulmonary bypass surgery.

Alarm management in intensive care units has emerged as a critical component of patient safety initiatives globally. The selection of appropriate outcome measures is important when designing alarm management interventions to accurately assess their clinical efficacy. This review examines and categorizes evaluation indicators employed in ICU alarm management programs internationally，synthesizing commonly utilized indicator sets and assessment methodologies. A comprehensive alarm management evaluation indicator set should incorporate both objective and subjective parameters across three key domains：structural （alarm system infrastructure），process （alarm frequency，type，time patterns，and balancing metrics），and outcome measures （healthcare provider experience，behavioral responses，and adverse event rates），in order to standardize clinical alert management. However，the effectiveness of these evaluation indicators requires further verification and improvement.

Objective To design a visualized navigational extracorporeal membrane oxygenation（ECMO） prefilling device and evaluate its application effect in the pre-filling training of ICU nurses. Methods A visual navigation ECMO pre-filling device was designed. A quasi-experimental research method was adopted. ICU nurses who participated in the ECMO pre-filling training in a tertiary grade A hospital in Hangzhou were selected as the research subjects. Nurses who participated in the training from July to December 2024 were selected as the experimental group（n=35），and the training was conducted using a visual navigation-type pre-filling device. From January to June 2024，the nurses who participated in the training were the control group（n=30），and the traditional training methods were adopted. The operation practice time，error rate，assessment scores，satisfaction and self-confidence scores of the two groups of nurses were compared. Results The operation practice time of the experimental group[90（45，100） min] was significantly shorter than that of the control group[95（60，120） min]. The operation error rate of the experimental group was 48.2%，which was lower than that of the control group（60.0%）. The operation assessment score was（94.11±1.76） points，which was higher than that of the control group（92.83±1.99） points. The self-confidence score （3.91±0.92） points and the satisfaction score（4.51±0.61） points were both higher than those of the control group（3.40±1.04） points and（4.03±0.77） points，and the differences were statistically significant（P<0.05）. Conclusion The visualized navigation-type ECMO pre-filling device can effectively improve the training efficiency of ICU nurses，enhance their operational experience，and boost their confidence in clinical operations.

Objective To design an anti-splashing anal fecal specimen sampler for infants and young children，and evaluate its application effectiveness. Methods The sampler was made of medical-grade flexible plastic material，integrating a liquid-storage balloon for suction under negative pressure，a one-way valve on a ventilation tube to prevent splashing，and a pre-lubricated coating structure. It was sterilized with ethylene oxide and packaged in independent paper-plastic packaging. For clinical application，400 infants requiring fecal sampling at a tertiary Grade A hospital in Hangzhou from March to April 2025 were selected and randomly divided into an experimental group （using the novel sampler，n=200） and a control group（using traditional anal swabs，n=200）. The success rate of sample collection，intestinal mucosal injury rate，fecal splashing rate，pediatric comfort level，and nurse satisfaction were compared between the two groups. Results The success rate of sample collection in the experimental group was 100.0%，significantly higher than that in the control group（93.0%）（χ²=14.508，P<0.001）. The mucosal injury rate（0 vs 3.0%，P=0.013） and fecal splashing rate（0 vs 7.0%，P<0.001） in the experimental group were significantly lower than those in the control group. The proportion of moderate to severe discomfort in the experimental group（23.0%） was lower than that in the control group（41.0%），and nurse satisfaction in the experimental group（98.0%） was higher than that in the control group（86.0%），with all differences being statistically significant（P<0.001）. Conclusion This design significantly enhances the safety and operational efficiency of fecal sampling in infants and young children，achieving zero mucosal damage and zero splash contamination，thereby increasing the comfort of pediatric patients and the satisfaction of nurses.