AIMS:To explore the potential risk factors contributing to inadequate bowel preparation in middle-aged and elderly patients (aged 40 and above) undergoing colonoscopy, and to subsequently devise and validate a comprehensive risk assessment tool and nomogram model for accurately predicting such preparation. DESIGN:A retrospective observational study was conducted at three campuses from January 2023 to December 2023. METHODS:Twenty-three clinical indicators derived from colonoscopy records were leveraged to inform the predictive models. By using multivariate and stepwise logistic regression analyses, a risk-scoring model and a nomogram prediction model were devised. Calibration curves were used to evaluate the model's accuracy, while decision curve analysis (DCA) and receiver operating characteristic (ROC) curves were used to evaluate the model's clinical applicability and discriminatory power, encompassing the Hosmer-Lemeshow χ2 test for goodness-of-fit. TRIPOD was used to guide this study. RESULTS:A total of 6860 outpatients who met the criteria were selected and divided into a training set (n = 4116) and a validation set (n = 2744) according to the bowel preparation quality. BMI, comorbidity, history of constipation, frailty degree, prescribing doctor's specialty, nonpatient's own prescribing, anxiety level and abdominal surgery history were independent risk factors for inadequate bowel preparation. The corresponding risk scores were 2, 0, 2, 4 3, 3, 2 and 1 respectively; with a total score of ≥ 8.5 classifying patients into a high-risk group. The area under the curve for the training and validation sets were 0.740 and 0.730, respectively, and an optimal critical value threshold of 34%. DCA findings demonstrated that the nomogram model was clinically helpful throughout a broad threshold probability range. CONCLUSIONS:The risk prediction nomogram model and assessment tool constructed in this study can help clinicians identify individuals at high risk for inadequate bowel preparation at an early stage, which is a guideline for personalised prevention and treatment. TRIAL AND PROTOCOL REGISTRATION:The name of the trial register was outpatient discharge management after general intravenous anaesthesia. The clinical trial registration was 2024-0116, and the link to the trial at the registration website was https://ctms.z2hospital.com:8443/. REPORTING METHOD:Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD) checklist. PATIENT OR PUBLIC CONTRIBUTION:Data for this study were provided by 7724 outpatients over 40 years old who underwent their first colonoscopy between January 2023 and December 2023 at three campuses of a medical centre.

Background: The advancement of endoscopic techniques has resulted in an increasing need for comprehensive competency in endoscopy nursing. However, there is currently no unified competency evaluation index system for nurse endoscopists in China. Aims: To develop and validate of a competency evaluation index system for nurse endoscopists with different stages performing endoscopy nursing in China. Design: A modified Delphi study. Settings: Data were collected in a medical university affiliated hospital. Participants: A total of 569 participants in different fields were included at various phases of this research. Methods: The preliminary indicators were designed after conducting a literature review, semi-structured interviews and questionnaires. Two rounds of correspondence with 30 experts using the Delphi method were conducted to evaluate the content of the index followed by reliability and validity tests. The competency evaluation index system for nurse endoscopists at different stages was developed through expert meetings based on the Delphi consultation results according to the novice-to-expert model. Results: After two rounds of Delphi method consultation, we have established 4 first-level indicators ('Cognitive skill', 'Practice professional skills', 'Professional development skills' and 'Personal characteristics and inner qualities') and 21 s-level indicators, which are the detailed description of first-level indicators. According to the index weight analysis, the four first-level indicators are ranked from the largest to the smallest as practical professional skills, cognitive skills, professional development skills, personal characteristics and intrinsic qualities. Three different stages of nurse endoscopists competency evaluation forms and criteria were developed: primary stage (New skilled), intermediate stage (Capable) and advanced stage (Expert). Conclusions: The establishment of a competency evaluation index system based on the novice-to-expert model can accurately assess competency levels and help to effectively train the nurse endoscopists at different stages. Future research should focus on imbedding these competencies in nurse education.

Background The efficacy of establishing an intensification outpatient center for diagnostic and treatment endoscope services has been documented, but its practical implementation remains limited. Presently, there are two models for outpatient endoscope care services: the clinical specialty-based model and the solitary outpatient model. However, each model has its limitations. Aims In this study, we introduce a nurse-led service model that offers comprehensive care throughout the entire journey for patients undergoing painless endoscopic treatment procedures outside the operating room overseen by anesthesiologist and report its implementation in an university-affiliated hospital. Design A single-center observational study. Methods Data was collected all of 2013 and 2022 at a tertiary medical hospital center. A total of 168,100 patients undergoing endoscopic anesthesia were included in the analysis. Patients receiving endoscopic diagnosis and treatment were divided into two groups: the Model-2013 (clinical specialty endoscopy service model, from January to December 2013) and the Model-2022 (nurse-led service model under the supervision of anesthesiologists, from January to December 2022). We conducted a retrospective analysis of workload data and compared the nursing quality management index of endoscopy center between Model-2013 and Model-2022. Results In 2013, the workload for digestive endoscopy was 28,864 procedures, while in 2022, it had significantly increased to 139,236 procedures. Patient satisfaction had risen from 93.99% to 95.25%, and the satisfaction of the collaborative team increased from 91.77% to 98.10%. The endoscopic cancellation rate dropped from 13.56% to 8.75%. The quality indicators for anesthesia nursing and endoscopy nursing had improved significantly without an increase in equipment and nursing costs (p < .05). Conclusion The nurse-led service model for patients undergoing painless endoscopic procedures outside the operating room can enhance service efficiency and patient safety and satisfaction, and can serve as a viable alternative to the traditional models based on clinical specialty and independent single endoscopy department.

The number of risk prediction models for esophageal stricture following endoscopic submucosal dissection (ESD) has been increasing steadily, yet their methodological quality and clinical applicability remain under-evaluated. This study systematically evaluates existing models to inform evidence-based selection and use in clinical practice and future research. A systematic search was conducted across both international and Chinese databases, including PubMed, Web of Science, Cochrane Library, Embase, CINAHL, CNKI, Wanfang Database, VIP, and SinoMed, covering the period from database inception to December 2024. The PROBAST checklist assessed the risk of bias and applicability of the models. Meta-analyses of predictive factors and were conducted using RevMan 5.4. A total of 13 studies were included, involving 13 risk prediction models. The area under the receiver operating characteristic curve (AUC) of the models ranged from 0.624 to 0.934, with 10 models having an AUC > 0.8. Quality assessment results indicated all 13 studies had a high risk of bias but demonstrated good applicability. Meta-analysis identified lesion location, lesion longitudinal diameter ≥ 4 cm, circumferential extent ≥ 1/2 or ≥ 3/4, histological invasion depth ≥ M2 or M3 SM1, and damage to the muscularis propria as significant predictive factors for esophageal stricture after esophageal ESD (P < 0.05). Among them, muscularis propria injury was the most reliable predictor (OR = 5.53, 95

PURPOSE:To enhance patient safety and improve communication and response times during the perioperative management of patients with acute upper gastrointestinal bleeding, a checklist was developed, tested for psychometric properties, and implemented in clinical practice. DESIGN:This is a methodological study. METHODS:A perioperative checklist for acute upper gastrointestinal bleeding was developed using a literature review and the Delphi method. The psychometric properties of the checklist were assessed through reliability and validity testing, including Cronbach's α coefficient, split-half reliability, content validity, and construct validity. A pre-and-post intervention study was conducted to evaluate the checklist's practical impact on clinical outcomes. Data were collected on safety indicators, efficiency metrics (including response times), and satisfaction levels. FINDINGS:The final checklist comprises 19 items across 3 domains: preoperative, intraoperative, and postoperative management. The Cronbach's α coefficient was 0.775, indicating good internal consistency. Split-half reliability was 0.701. The scale-content validity index/average for the 3 domains was 0.987, 0.971, and 0.904, respectively, while the item-content validity index ranged from 0.857 to 1.000, demonstrating excellent content validity. Factor loadings for each item exceeded 0.5, and 6 latent factors explained 83.874% of the total variance, confirming the checklist's strong factor structure. In the clinical application, 210 cases were analyzed-101 before and 105 after checklist implementation. The response time for emergency endoscopy improved significantly (t = -2.556, P < 0.05). Additionally, satisfaction with team collaboration showed significant improvement (χ2 = 8.56, P < 0.05), highlighting the checklist's effectiveness in enhancing clinical outcomes and coordination among the health care team. CONCLUSIONS:The perioperative checklist for acute upper gastrointestinal bleeding demonstrates strong reliability, validity, and practical utility. Its application improves response times, patient safety, and teamwork, making it an effective tool for perioperative management in patients with acute upper gastrointestinal bleeding.

PURPOSE:To analyze the correlation between perioperative electronic health literacy (e-health literacy) and the quality of bowel preparation based on investigating the risk factors associated with inadequate bowel preparation in colonoscopy patients. DESIGN:A prospectively observational study conducted at three tertiary endoscopy centers in China. METHODS:In total, 9,618 patients who underwent their first colonoscopy scanning from July 2023 to June 2024 were collected. Logistic regression analysis was used to identify independent risk factors for bowel preparation failure, while 1:1 propensity score matching was employed to compare the quality of bowel preparation based on different e-health literacy levels. FINDINGS:About 24.55% of patients were experiencing inadequate bowel preparation. Moderate-to-severe anxiety, male, primary school education level, nondigestive endoscopy specialist prescribing, more than 7 days between prescription and treatment time, and low perioperative e-health literacy levels were the independent risk factors for inadequate bowel preparation (P < .05). Inadequate bowel preparation in patients with low perioperative e-health literacy group was predominantly seen in the right and left colon and the proximal colon. CONCLUSIONS:Perioperative e-health literacy is an independent risk factor for the quality of bowel preparation. The results highlight the need for developing a customized education intervention program that can improve perioperative e-health literacy for successful preoperative preparation.

Background Postoperative fatigue (POF) widely exists in patients underwent digestive endoscopy under anesthesia, seriously affecting patients’ postoperative rehabilitation and quality of life, there is few predicted tools for POF. We aim to identify predictors of 24 hours-postoperative fatigue (24h-POF) in patients underwent digestive endoscopy with anesthesia assistance and develop a nomogram. Methods This cross-sectional study involved 1306 patients underwent digestive endoscopy in The Second Affiliated Hospital Zhejiang University School of Medicine from May to November in 2023. Christensen Fatigue Scale was used to evaluate POF. Multiple linear regression analysis was utilized to ascertain independent predictors, and a nomogram was developed based on these findings. The area under the curve (AUC), calibration curve and decision curve analysis (DCA) were employed to evaluate the predictive model’s performance. Results 528 patients (40.43%) reported experiencing 24h-POF. Five modifiable factors (preoperative anxiety, average dosage of propofol, change rates of heart rate, fatigue 30 min after endoscopy, intraoperative hypotension) and nine non-modifiable factors (age, gender, drinker, numbers of comorbidities, degree of education, marital, Buddhist, endoscopic treatment, intraoperative tracheal intubation) were independently associated with 24h-POF in patients undergoing digestive endoscopy. The model exhibited good discrimination with an AUC of 0.865 and 0.891 in training cohort and validation cohort, respectively. The calibration curves and DCA curves demonstrated excellent calibration and clinical practicability. Conclusion The nomogram can effectively predict 24h-POF of digestive endoscopic patients, providing valuable assistance for early intervention to expedite patient recovery.

PurposeThe purpose of this study was to develop a discharge assessment scale tailored for outpatients undergoing sedative anesthesia treatment in the ambulatory postanesthesia care unit and validate its agreement with the Post-Anesthetic Discharge Scoring System.DesignThe Delphi method.MethodsA Delphi survey was conducted with 30 experts focusing on the evaluation of outpatient discharges following treatment under ambulatory anesthesia. Subsequently, a cross-sectional observational study employing convenience sampling selected 2,579 outpatients who had undergone painless ambulatory gastrointestinal endoscopy at a tertiary hospital to analyze the level of agreement with the Post-Anesthesia Discharge Scoring System.FindingsThe study conducted three rounds of expert consultations to create the ambulatory discharge assessment scale. Twenty-five experts from 12 provinces and municipalities in our country were interviewed. The discharge assessment form encompassed five aspects: consciousness level, vital signs, directional stability, mobility, and adverse reactions. According to the scale, if the total score exceeded 9 points, with none of the items scoring 0 points, the ambulatory patient could be discharged from the hospital with the accompaniment of family members. Patients assessed using this newly constructed scale were able to leave the hospital earlier compared to those assessed using the comparative scale. No significant differences were observed in vital signs at the time of discharge or the occurrence of adverse events within 24 hours after the procedure.ConclusionsThis assessment tool for discharging ambulatory patients after the ambulatory anesthesia from the postanesthesia outpatient care unit can be considered a valuable addition to formalize the discharge process in outpatient services.

PurposeTo verify the feasibility of clinical-based discharge (CBD) criteria and to find out the reasons for the delayed discharge of outpatients after endoscopy procedures under drug-induced intravenous sedation.DesignA prospectively observational study conducted at a tertiary endoscopy center.MethodsMedical records were collected from outpatients admitted for endoscopy procedures under drug-induced intravenous sedation from June 1, 2021 to December 30, 2021. Patients were scheduled to discharge at least 30 minutes based on the time-based discharge (TBD) method. Postanesthetic discharge scoring system in the outpatient post-anesthesia care unit (PACU) recorded the time of patients discharged home on the CBD criteria. Postoperative complications were recorded in the PACU and within 24 hours after discharge. Multivariate analysis was applied to identify the factors relating to late discharges.Findings10,597 patients were safely and successfully discharged home, and we were informed of no serious emergency or accidental readmissions to the hospital. The mean CBD time (21.77 ± 11.35 minutes) was compared with the TBD time (30 minutes) and actual TBD discharge time (61.56 ± 4.93 minutes), which were statistically significant, without changes in the patient's vital signs (P < .01). Primarily, further univariate and multivariate analyses showed that abdominal pain and fatigue were key factors accountable for delay in PACU discharge (P < .05).ConclusionsThe study concluded that in patients undergoing ambulatory endoscopy procedures with drug-induced intravenous sedation, discharge times based on physiological scoring systems can efficiently and safely guide ambulatory patient discharge as compared to the traditional TBD method. Postoperative fatigue and pain were the main factors affecting patients discharge associated with a relatively long PACU length of stay.

Purpose: The aim of this review was to explore the existing literature on discharge criteria, tools and strate-gies used in the postanesthesia care unit (PACU) after ambulatory surgery and to identify the essential com-ponents of an effective and feasible scoring system based on applicable criteria for the three phases of anesthesia recovery to assess patient discharge after outpatient anesthesia. Design: A review of the literature.Methods: In this study, a review of sixteen articles was conducted to analyze the affecting factors, evaluation tools, and the current research status of patients discharge after outpatient anesthesia. Findings: The main factors affecting the discharge after diagnostic or therapeutic procedures under outpatient anesthesia were hospital management, medical treatment and patients themselves. Physiological systems-based discharge assessment had several advantages over traditional time-based discharge assessment. The Aldrete scoring scale was often used for patients in the first stage of anesthesia recovery to leave the PACU, and the Chung's scoring scale was often used to evaluate patients in the second stage of recovery until they leave the hospital. These two scales were often used in combination for outpatient anesthesia. The Fast-track-ing assessment tool was used in patients who directly returned to the ward or discharge of patients after ambulatory surgery. There is currently no uniform standard or tool for assessing patients discharge after diagnostic or therapeutic procedures under the outpatient anesthesia.Conclusions: Optimal care under anesthesia should allow the patient to recover from anesthesia smoothly and quickly and leave the hospital safely. When the patients can safely leave the hospital after outpatient anesthesia is still a problem that needs to be solved in the nursing field. Various existing scoring systems have their historical advancements, but we need to formulate more in line with the current status of postop-erative patients discharge standards.& COPY; 2022 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

目的 探讨单人操作导丝乳头插管法与双人操作导丝乳头插管法在内镜逆行胰胆管造影术(ERCP)中的应用效果.方法 回顾性分析2019年2月-2021年2月因胆胰疾病行ERCP治疗的445例患者的临床资料,比较两种乳头插管技术在ERCP中的插管成功率和术后并发症发生情况,并初步分析术后并发高淀粉酶血症的危险因素.结果 插管总成功率为97.3%.其中,单人插管组成功率为97.5%,双人插管组成功率为97.1%,两组患者术后并发症比较,差异无统计学意义(P = 0.782).术后发生胰腺炎22例(4.9%),高淀粉酶血症105例(23.6%),两组患者术后并发症比较,差异无统计学意义(P>0.05).单人插管组和双人操作组插管时间为(7.15±0.48)和(10.70±0.71)min,ERCP完成时间为(19.24±1.26)和(23.11±1.64)min,住院时间中位数为9.0和11.0 d,单人插管组均短于双人插管组,差异有统计学意义(P<0.05).结论 两种乳头插管技术ERCP插管成功率和术后并发症发生率无明显差异,单人插管技术因不需要助手密切配合,有利于缩短插管时间,减少导丝进入胰管频率和乳头损伤,降低术后并发症发生率,从而缩短住院时间.值得临床推广应用.

消化电子内镜术是指在光线照明下可直视胃肠道及腹腔内脏器病变的一种管状器械检查[1 ].消化电子内镜诊疗凭借其创伤小、痛苦少、恢复快的优点,在消化道疾病的诊断和治疗中发挥着越来越重要的作用.据统计,2019年全国共开展消化内镜诊疗3873万例[2 ].在临床操作过程中,常规消化电子内镜下获取病理活检或诊疗时,均需要使用附件器械通过内镜腔道完成.部分医生在操作附件器械插入内镜腔道时,因插入速度不当使器械头端快速冲出腔道导致消化道黏膜损伤出血,甚至导致穿孔等不良事件.安全警示标识属于一种风险管理或风险控制策略,是指针对各种风险事件,采用不同颜色或图案设计、制作的有针对性、目的性和科学性的警示标识,起到提醒作用[3 ].研究发现,实施警示标识是将患者的风险事件消灭在萌芽状态而采取的一种管理方法,达到促进患者安全的目的[4 ].为避免在内镜诊疗操作中,因附件器械插入速度不当导致的意外事件,笔者设计一种带警示标识的改良型消化电子内镜附件器械(专利号:Z L 202121857452 .3 ) ,经临床使用,取得较好效果.现报告如下.

消化道异物是指在消化道内不能被消化且未及时排出而滞留的物体，因异物的种类、停留部位及时间不同，临床表现不一。80%~90%消化道异物可自行排出，10%~20%的异物需内镜处理，仅1%的异物需要外科手术 [1,2]。在消化道异物中，约85%上消化道异物为食管异物 [3,4,5]，结肠异物较上消化道异物少见，因整个结肠较长、生理弯曲较多、操作空间小，加之尖锐异物易导致穿孔、出血的发生，使得内镜下取物困难。若未发生出血或穿孔等并发症，则可通过内镜取出。本文报道1例内镜下成功取出迁移性尖锐异物，患者未发生穿孔、出血等并发症，并于术后1 d出院，现报道如下。

Objective:To assess the nursing care experiences and curative effects of the application of wound care technologies combined with other multiple treatments in the hepatolithiasis patient who suffered from postoperative severe intestinal fistula.Methods:The wound care difficult points were analyzed,the wound care technologies combined with other multiple treatments including multiple debridement methods were applied according to the severity of the intestinal fistula:multiple debridement, new skin protection, continuous flushing and drainage with double cannula, improved negative pressure closure drainage and wound pull-in technology, combined with systemic treatment and nursing intervention.Results:The intestinal fistula was treated for 12 days, and the wound infection was controlled for 24 days. Finally the wound was healed after 43 days and patient was discharged from hospital.Conclusions:In the case of severe intestinal fistula after hepatolithiasis operation, the application of wound nursing technology combined with treatment scheme provides a new treatment idea and scheme for intestinal fistula and wound healing.

急性口服中毒患者约占急诊抢救患者的15％～20％,且具有进展快、预后差的特点,彻底清除胃肠道毒物、最大限度减少毒物吸收是关键[1].洗胃是抢救的首要措施[2],但反复快速充盈排空胃体,易引发恶心、呕吐,导致导泻剂不能尽早顺利进入肠道;中毒后机体保护机制的启动和大量拮抗药物的应用,在一定程度上抑制肠道蠕动,影响肠道内毒物排出,加重患者病情[3];此外由于急性中毒病因及表现的多样性,导泻效果不能达到预期,严重影响抢救成功率.目前中医治疗技术如针灸、中药灌肠、导泻、穴位贴敷等在急性中毒临床诊疗中逐步应用,并取得一定的疗效[4-5].本研究拟在西医洗胃治疗的基础上联合中医穴位贴敷及穴位按摩治疗,探讨中西医结合对急诊中毒患者的治疗效果,现报道如下.

Introduction: Desmoid-type fibromatosis (DF) is a fibrous tumor characterized by low-grade malignant and easy invasive growth and high recurrence. High-intensity focused ultrasound (HIFU) therapy has been identified as a novel non-invasive approach for DF treatment; however, the ultrasonic energy generated by HIFU can cause skin heat injury. Case: A 31-year-old female patient with signs and symptoms of DF received treatment in our institution. The patient had undergone HIFU treatment six times from April 27, 2018, to August 21, 2019. After HIFU therapy for the third time, she had a third-degree skin burn showing as orange peel-like change and spent three months to promote the recovery of the skin lesions. An intermittent ice-cooling strategy was used to avoid skin damage during the fourth HIFU treatment. This patient did not have any apparent skin injury during the last three HIFU therapy and acquired satisfactory anti-tumor therapeutic effect. Conclusions: There are differences in the thermal selectivity of tumor tissues, which leads to different critical thermal injury temperature values that the tissue can tolerate. Ice-cooling can lower skin tissue temperature and reduce the thermal damage caused by HIFU treatment.

目的 观察门诊慢病健康管理平台应用于中青年高血压患者中的效果.方法 构建门诊慢病健康管理平台,对172例门诊中青年高血压患者进行慢病健康管理,包括线下就诊服务、专科化健康宣教、慢病健康管理信息推送、线上监督咨询管理等,比较慢病健康管理平台应用前及应用3个月、6个月、12个月后中青年高血压患者健康素养、自我管理行为和血压达标率.结果 门诊慢病健康管理平台应用后,中青年高血压患者的健康素养、自我管理健康行为随着时间延长均呈现提高趋势(P<0.05);血压达标率从34.88％ 提高至61.05％,差异有统计学意义(P<0.05).结论 门诊慢病健康管理平台的应用,可提高中青年高血压患者健康素养水平,改善其自我管理行为和血压达标率.

目的 构建公共平台下的内镜中心亚专科护理模式,并探讨其应用于临床的效果.方法 我院于2016年构建亚专科护理组织架构,并应用于临床.将该模式应用前12个月的数据作为应用前,应用后12个月的数据作为应用后;比较该模式应用前后全科内镜护士接受理论与操作考核成绩,医生对护士满意度评价、护士对工作满意度评价、全院对特殊单元服务对象满意度评价,年工作量、内镜维修数量、年不良事件发生数量.结果 亚专科护理模式应用后,护士理论与操作测试得分提高(P<0.05),医生对护士满意度、护士对工作满意度自评、全院对特殊单元服务对象满意度评价得分得到提高(P<0.05),年度内镜工作量得到改善、内镜维修量及不良事件发生情况降低(P<0.05).结论 开展内镜中心亚专科护理模式,有利于提高护士临床工作综合能力,提升专科护理水平,提高护理服务质量,深化优质护理内涵;降低科室成本,促进经济效益的提升,值得临床推广.

Background: Effective pain management is closely related to the prognosis of patients after surgery. Setting up acute pain service is among the effective strategies to control pain. The operation of acute pain service is mostly dominated by anesthesiologists; however, control of postsurgical pain is still unsatisfactory. Nurses are the main force for providing postoperative care of patients, and their role in acute pain service is crucial. Therefore, in the current study, we have developed a nurse-led pain relief model that emphasizes the central role of nurses during the entire surgical procedure. However, the effect of using this model for pain management among abdominal surgical patients remains unknown. Aims: The current study was conducted to investigate the effect of using a nurse-led pain relief model for pain management among abdominal surgical patients. Design: A single-center, propensity score-matched, controlled before-after study. Methods: The patients, hospitalized for abdominal surgery in a university-affiliated hospital from January 2015 to December 2017, were enrolled and divided into group A (hospitalized before nurse-led pain relief model implementation, from January, 2015 to October, 2016) and group B (hospitalized after nurse-led pain relief model implementation, from October, 2016, to December, 2017) using propensity score match assay. The researchers compared the quality of acute pain management, the main side effects of pain management, and nurses' pain knowledge and attitude between group A and group B. Results: A total of 2851 patients undergoing nonemergency abdominal surgery were enrolled in the current study and were propensity matched 1:1 into two groups with 1,127 subjects in each group. The quality of acute pain management postsurgery was better after implementation of the nurse-led pain relief model. More patients received higher numerical rating scales cores (>= 4 points) at indicated time points after surgery in group A compared with group B (14.20% vs. 12.24% 6 hours postsurgery, p = .001; 12.33% vs. 8.52% 12 hours postsurgery, p = .004; 12.95% vs. 3.99% 24 hours postsurgery, p = .036; 16.06% vs. 7.19% 48 hours postsurgery, p = .001). Furthermore, the occurrence of nausea and vomiting during pain management were significantly decreased in patients from group B (nausea: X-2 = 38.926, p<.05; vomit: X-2 = 39.302, p<.05). Additionally, after using the nurse-led pain relief model, nurses were more open to improving their knowledge and attitudes to pain management (p<.05). Conclusion: Our study demonstrated that a nurse-led pain relief model can enhance the quality of acute pain management among post-abdominal surgical patients, suggesting that such a model can be an effective intervention for providing a better pain control among postsurgical patients. (C) 2020 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.