ObjectiveTo develop a treatment adherence scale for post⁃bariatric surgery patients and test its reliability and validity.MethodsThe item pool was constructed through literature analysis and semi⁃structured interviews.The final scale was formed after expert consulation and a pre-survey.Using convenience sampling,a total of 424 post⁃bariatric surgery patients from the obesity clinic of a tertiary grade A hospital in Chongqing city were selected as subjects to evaluate the scale's reliability and validity.The study period spanned from September 2023 to January 2024.ResultsThe final scale comprised 21 items across 6 dimensions,namely outpatient follow⁃up,nutritional supplement intake,fluid intake,dietary behavior,medication-taking behavior,and physical activity.Exploratory factor analysis extracted 6 common factors,with a cumulative variance contribution rate of 69.544%.Confirmatory factor analysis indicated a good model fit.The standardized factor loading for the scale dimensions ranged from 0.52 to 0.93(P<0.05).The average variance extracted(AVE) values for the scale dimensions ranged from 0.404 to 0.817.The composite reliability values ranged from 0.728 to 0.930.The correlation coefficient ranged from 0.194 to 0.594(P<0.05).The square roots of the AVE values(ranged from 0.635 to 0.903) were all greater than the correlation coefficients between the corresponding dimension and other dimensions.The scale's content validity index was 0.904.The Cronbach's α coefficient was 0.879.The test⁃retest reliability was 0.894.ConclusionsThe developed treatment adherence scale for post⁃bariatric surgery patients demonstrates acceptable reliability and validity.It could serve as an effective tool for assessing treatment adherence in post⁃bariatric surgery patients.

OBJECTIVE:This study aims to examine the current state, influencing factors, and pathways of safety behavior among registered nurses in China, thereby providing a theoretical framework for enhancing safety behavior levels among registered nurses. METHODS:The research involved the recruitment of registered nurses in Chongqing, China, utilizing the snowball sampling technique from July 2022 to May 2023. RESULTS:A total of 3244 registered nurses from 115 hospitals in Chongqing participated in the study. The mediation effect model demonstrated a good fit, with all variables accounting for 35% of the variance in safety behavior. The most significant influencing variables identified were perceived organizational support, patient safety competency, satisfaction with information systems, and patient safety training, with total effects of .44, .15, .12, and .12, respectively. CONCLUSION:The mediation effect model revealed that perceived organizational support has a direct impact on safety behavior and can also influence safety behavior indirectly through patient safety competency. It is crucial to continuously enhance the patient safety competency of registered nurses, cultivate a supportive and compassionate organizational culture, encourage the implementation of safety behavior among nursing personnel, and ultimately ensure patient safety.

Accidental perioperative hypothermia is a common but preventable surgical complication. This study aimed to review the risk factors for hypothermia in major abdominal surgery patients. Databases (CINAIL via EBSCO, Embase, Ovid MEDLINE, and Cochrane Center Register of Controlled Trials) were searched from inception to September 27, 2022. Meta-analyses were performed to calculate the pooled effects of risk factors. The Newcastle-Ottawa Scale was used to assess the quality of studies, and heterogeneity was examined by I-square tests. A total of 12 studies were involved in this review. The meta-analysis showed that hypothermia had an association with ASA (OR 0.48, 95

Background and Aims:New nurses are an important part of nursing teams. The failure of new nurses to successfully transition seriously affects personal career development and nursing work quality, and important influencing factors deserve the attention of nursing managers. At present, multicenter, large-sample investigations of transition shock among new nurses are lacking in China. This study aims to investigate the current level and influencing factors of transition shock among new nurses in China. Methods:We conducted a multicenter, cross-sectional study with 3414 new nurses from 16 provinces in 7 regions in China from October 22, 2021, to November 8, 2021. We used the snowball sampling method and an online questionnaire produced by the researchers to collect data; the questionnaire included questions on demographic information, a transition shock scale for new nurses and open-ended questions. Data were analyzed using SPSS version 24. Results:The effective response rate of this study was 97.89%, with 3342 effective participants from 189 hospitals in China, most of whom were female (94.88%). The study showed that the transition shock of new nurses in China was at a moderate level, with pre-job anxiety, unsatisfactory welfare treatment, resignation intention, adverse events, poor sleep quality, 1 or fewer exercise sessions per week, inability to balance work and life, and gluttony negatively affecting the transition shock of new nurses in China. Psychological shock was the strongest among the four dimensions of transition shock. Conclusions:The transition shock of new nurses, especially their psychological shock, deserves more attention from international society. Nursing managers should continue to take supportive measures to intervene in the factors influencing transition shock, with the aim of reducing the level of transition for new nurses, promoting their personal thriving, improving the quality of nursing work and increasing the retention rate of nurses.

目的 了解疫情常态化期间护工在照护老年人过程中的真实体验和心理感受,为进一步规范护工照护行为,改善现状、提升照护能力提供依据.方法 2020年7月1日至8月15日依据诠释性现象学研究方法对重庆市某三甲综合医院老年病科9名护工进行半结构式访谈,采用Van Manen分析方法进行分析.结果 针对护工照护老年住院患者的工作体验和感受提炼出矛盾的真实体验和感受、多重角色的调和、职业发展需求3个主题,第1个主题包含负性体验、积极照护感受2个亚主题;第2个主题包含与医务人员的互补关系、与患者家属的雇佣关系、与老年患者的陪伴关系、与家人的亲情关系4个亚主题;第3个主题包含加强培训、优化管理模式2个亚主题.结论 护工这个特殊的群体是介于医务人员、老年人及患者家属之间的照护力量,医疗机构应规范护工的管理制度,明确准入标准,加强培训,为老年护理事业的发展提供保障.

Unplanned intraoperative hypothermia is a complication that can lead to a variety of negative outcomes, such as cardiovascular events. We aimed to develop and validate an intraoperative hypothermia risk prediction nomogram for patients with colorectal cancer undergoing laparoscopic colorectal procedures. We conducted a prospective cohort study with 1,091 patients (ie, 765 in the training cohort, 326 in the validation cohort) from October 2020 to November 2021. We included six predictors in the nomogram model: body mass index, diabetes diagnosis, ambient temperature, ambient humidity, duration of surgery, and use of a forced-air warmer. The model performed well, and the area under the curve was 0.855. These results, together with an external validation value, mean that health care professionals can use the nomogram to calculate the intraoperative hypothermia risk for patients undergoing laparoscopic colorectal procedures and make clinical decisions based on the results.

Abstract Background and Aims The novel coronavirus disease 2019 (COVID‐19) causes severe respiratory illnesses, following exposure to air‐borne droplets or direct contact, posing a great threat to human life. This study aimed to investigate perceived stress and its correlation with the health behaviors of Chinese residents during the COVID‐19 epidemic. Methods An Internet survey was conducted among 2449 residents in 20 provinces of China on residents' perceived stress, perception of COVID‐19, and health behaviors. SAS 9.4 was used to analyze the relationship between health behaviors and perceived stress, and logistic regression was used to explore the factors influencing health risk stress. Results The participants' perceived stress score was 22.25 ± 7.2 (total 56), and the incidence of health risk stress was 39.89% (977/2449). Females, students, and medical staff were at high risk. Health risk stress refers to a level of stress that is hazardous to health (score over 25). Perceived stress increased, while the frequency of health behaviors decreased. Age, perception of susceptibility to COVID‐19, life‐threatening level of COVID‐19, perception of the importance of home isolation, and perception of the difference between a common cold and COVID‐19 were positively related to the occurrence of health risk stress. Conclusions A negative correlation was found between health behaviors and perceived stress. Therefore, it is of great significance to provide psychological interventions for those who are experiencing health risk stress and to promote their health behaviors.

目的 分析提高医疗质量和患者安全的团队策略和工具包(TeamSTEPPS)在患者安全中的应用现状,为构建符合我国医疗环境的TeamSTEPPS患者安全培训体系提供依据.方法 检索中英文数据库关于TeamSTEPPS应用的相关文献,并进行文献筛选、资料提取及分析总结.结果 TeamSTEPPS在跨专业教学、临床培训、团队安全文化建设等方面应用广泛,能够促进团队协作,提高医疗护理质量.但TeamSTEPPS模式在我国仍处于初步探索阶段,尚未形成规范化培训体系.结论 建议强化多学科交叉融合,有机整合TeamSTEPPS培训与教学;确定TeamSTEPPS培训标准,完善评价体系;培育组织安全文化.

BACKGROUND:The most common and severe type of nosocomial infection in patients with colorectal cancer is surgical site infection (SSI). Patient-related factors are an important components of SSI. So it is necessary to participate in SSI prevention and control. It is important to identify the factors that influence patients' participation behaviour and to explore the mechanism of these effects.METHODS:A total of 580 patients with colorectal cancer completed relevant measures. Based on the extended theory of planned behaviour, a structural equation model was used to analyse the relationship among the influencing factors.RESULTS:The factors influencing participation of patients with colorectal cancer in SSI prevention and control were participation intention, participation ability, self-efficacy, participation attitude, perceived medical staff support, trust in physicians and social support. The direct effect coefficients of participation intention, participation ability and physician trust on SSI prevention and control behaviour were 0.67, 0.21 and 0.11, respectively. Self-efficacy, participation attitude, perceived medical staff support and social support indirectly affect participation behaviour through participation intention, and their effect values are 0.21, 0.11, 0.11 and 0.08, respectively.CONCLUSIONS:Based on the structural equation model developed in this study, targeted intervention measures should be implemented to mobilize the intention and enthusiasm of patients with colorectal cancer to participate in the prevention and control of SSI.PATIENT OR PUBLIC CONTRIBUTION:Patients or public contribute to spreading research findings, and promote broad participation in the implementation of policies or strategies.

Inadvertent intraoperative hypothermia (core temperature <36°C) is a common surgical complication with several adverse events. Hypothermia prediction models can be a tool for providing the healthcare staff with information on the risk of inadvertent hypothermia. Our systematic review aimed to identify, demonstrate, and evaluate the available intraoperative hypothermia risk prediction models in surgical populations.This study is a systematic review of literature.We systematically searched multiple databases (Ovid MEDLINE, Web of Science, Embase, and Cochrane Center Register of Controlled Trials). Two reviewers independently examined abstracts and the full text for eligibility. Data collection was guided by the CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies (CHARMS checklist), and methodological quality and applicability were assessed by the Prediction model Risk Of Bias ASsessment Tool (PROBAST).A total of 3,672 references were screened, of which eight articles were included in this study. All the models had a high risk of bias since most of them lacked model validation. Also, they failed to report the model performance and final model presentations, which restricted their clinical application.The researchers should present models in a more standard way and improve the existing models to increase their predictive values for clinical application.

PURPOSES:Inadvertent intraoperative hypothermia (core temperature <36°C) is a common surgical complication with several adverse events. Hypothermia prediction models can be a tool for providing the healthcare staff with information on the risk of inadvertent hypothermia. Our systematic review aimed to identify, demonstrate, and evaluate the available intraoperative hypothermia risk prediction models in surgical populations. DESIGN:This study is a systematic review of literature. METHODS:We systematically searched multiple databases (Ovid MEDLINE, Web of Science, Embase, and Cochrane Center Register of Controlled Trials). Two reviewers independently examined abstracts and the full text for eligibility. Data collection was guided by the CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies (CHARMS checklist), and methodological quality and applicability were assessed by the Prediction model Risk Of Bias ASsessment Tool (PROBAST). FINDINGS:A total of 3,672 references were screened, of which eight articles were included in this study. All the models had a high risk of bias since most of them lacked model validation. Also, they failed to report the model performance and final model presentations, which restricted their clinical application. CONCLUSIONS:The researchers should present models in a more standard way and improve the existing models to increase their predictive values for clinical application.

Purpose To describe the experience and support of Chinese healthcare professionals as second victims of PSIs. Design and Methods A cross-sectional study with anonymous online self-report questionnaires was adopted. A total of 1357 Chinese healthcare professionals participated in this study. The Chinese version of the Second Victim Experience and Support Tool (C-SVEST) was used to evaluate the experience of second victims and the quality of support resources. Descriptive and inferential statistics were employed to analyze the data. Findings This study showed that 350 participants (25.8%) had been involved in PSIs during their careers. The majority of respondents who had experienced PSIs agreed they suffered more from psychological distress, followed by professional self-efficacy distress, and physical distress. Besides, they regarded colleague support and management support as the most desirable support. Statistically significant differences were reported in some items. First, compared with medical staff without professional titles, staff with professional titles suffered more from psychological distress but gained more support from colleagues. Practice implications The second victim phenomenon deserves further attention. The programs focusing on training qualified colleagues to provide emotional support should be developed, implemented, and evaluated. Moreover, it is necessary to build a better patient safety culture with nonpunitive responses and encourage the disclosure and reporting of PSIs.

We propose a novel method for compressing Deep Neural Networks (DNNs) with competitive performance to state-of-the-art methods. We measure a new model-free information between the feature maps and the output of the network. Model-freeness of our information measure guarantees that no parametric assumptions on the feature distribution are required. The new model-free information is subsequently used to prune a collection of redundant layers in the networks with skip-connections. Numerical experiments on CIFAR-10/100, SVHN, Tiny ImageNet, and ImageNet data sets show the efficacy of the proposed approach in compressing deep models. For instance, in classifying CIFAR-10 images our method achieves respectively 64.50% and 60.31% reduction in the number of parameters and FLOPs for a full DenseNet model with 0.77 million parameters while dropping only 1% in the test accuracy. Our code is available at https://github.com/suuyawu/PEDmodelcompression

目的 探讨基于柯氏模型对TeamSTEPPS应用于医疗人员培训后效果维持系统评价.方法 计算机检索中英文数据库关于TeamSTEPPS应用于医疗人员培训的文献,2名研究者根据纳入与排除标准,独立进行文献的筛检、质量评价和资料提取.结果 共纳入9篇自身前后对照试验,结果显示,学员对TeamSTEPPS培训较满意,多数学员能保持较好的团队合作及沟通能力,形成稳定的患者安全文化,但培训后产生的良好患者安全结果,如手术准时开始率、手术周转时间、患者死亡率及并发症发生率等存在差异.结论 TeamSTEPPS培训能有效维持学员良好的团队合作及沟通能力,但对于客观培训结果的维持性,需进一步研究.

目的 总结手术患者非计划性术中低体温风险预测模型的研究进展,为未来模型的发展提供建议.方法 检索国内外关于非计划性术中低体温预测模型的文献,从模型推导形式、模型评价指标及模型验证范围等角度进行综述.结果 非计划性术中低体温预测模型研究开展较多,但普遍存在模型构建过程不规范、性能指标不完整、验证方式不完善等问题.结论 非计划性术中低体温预测模型作为筛查高风险人群的评估工具,可为医护团队术前识别术中低体温高风险患者并采取针对性预防措施提供依据.未来研究可从验证已有模型出发,完善模型性能评估指标,创新模型呈现方式,扩大模型验证范围,以期有效指导临床工作,保障患者安全.

患者安全是保障人民健康的重要举措,但以前患者安全并未受到医务人员和各级管理部门的重视,患者在就医过程中受到伤害的事件时有发生,导致不必要的医疗费用增加甚至危及患者生命.随着人们对患者安全的认识进一步加深,患者安全越来越受到医务人员的普遍重视,为让临床医学本科学生早期建立患者安全理念,强化学生安全意识和能力,本课题组在综合国内外患者安全教育模式的基础上,在医学本科教育中创新性开设患者安全课程,取得了较好的效果,增强了医学生患者安全的知识,提高了其患者安全的意识,培养了一批患者安全意识强、职业素质高的教学师资.

目的 研制结直肠癌患者参与手术部位感染防控意向及行为量表,并进行信效度检验.方法 依据互动式参与患者安全理论,利用文献研究、半结构式访谈、Delphi专家咨询法形成量表初稿.采用便利抽样法对重庆市某三甲综合医院320例结直肠癌患者进行调查,通过所得的数据测评量表的信度和效度.结果 结直肠癌患者参与手术部位感染防控意向及行为量表共26个条目,利用探索性因子分析提取出5个公因子,累积方差贡献率为67.615％.意向分量表和行为分量表的Cronbach'sα系数分别为0.941和0.937,2周重测信度分别为0.898和0.920.结论 量表信效度良好,符合心理学测量要求,可用于评估结直肠癌患者参与手术部位感染防控的意向和行为现状.

通过根本原因分析法,对1例潜在严重后果的手术患者止血药物近似错误案例进行剖析,探讨医嘱管理、相似药品、沟通不良、药物相关知识缺乏、惯性思维等对安全用药的影响.口头指示不清或不明可能导致用药错误,口头医嘱存在较高风险;医护人员用药知识不丰富是医嘱错误常见原因之一;系统不完善可能导致用药差错.确保用药安全需要优化制度流程,加强临床医务工作者的有效沟通与协作,强化医务人员角色功能定位以及完善系统等.

回顾了一例血标本标签粘贴错误的案例,通过分析事件根本原因,提出建立完善的抽血标准流程、合理安排护理人力资源、完善医院信息化管理制度等改进建议.指出,建立“非惩罚性”的患者安全事件报告制度,营造良好的患者安全文化氛围是促进医务人员积极上报不良事件的重要举措.

Aim: To analyse the patient safety competency (PSC) of Chinese nurses with associate degrees (ADNs) and explore factors. Design: A cross-sectional study. Methods: A convenience sample of 451 ADNs working in 18 hospitals located in Chongqing city of China was investigated using the Patient Safety Competency Nurse Evaluation Scale (PSCNES). Descriptive and inferential statistics were used to analyse the data. Results: ADNs had a moderate level of PSC. In terms of the six dimensions of PSC, ADNs performed well in clinical practice and safety risk management, while they performed poorly in patient-centred care and patient safety culture. Statistically significant differences were reported in two items. Firstly, ADNs who have participated in patient safety training had a higher level in all dimensions of PSC than those who have not participated in related training. Secondly, ADNs without professional titles had a higher level of patient safety culture than those with professional titles.