Search

Abstract Aims Trauma is the fifth‐leading cause of death in China. Despite the establishment of the Chinese Regional Trauma Care System (CRTCS) in 2016, advanced trauma nurse practice has not been incorporated. This study aimed to identify the roles and responsibilities of trauma advanced practice nurse (APN), and to investigate the impact on patient outcomes in a Level I regional trauma centre in mainland China. Design A single‐centre pre‐ and post‐control design was used. Methods The trauma APN programme was established based on multidisciplinary experts' consultation. A retrospective study was conducted on all Level I trauma patients over a period of 5 years, spanning from January 2017 to December 2021, with a sample size of 2420. The data were divided into two comparison groups: a pre‐APN programme (January 2017–December 2018; n = 1112) and post‐APN programme (January 2020–December 2021; n = 1308). A comparison analysis was conducted to evaluate the effectiveness of trauma APN who were integrated into the trauma care team, with a focus on patient outcomes and time‐efficiency indicators. Results The certification of the regional Level I trauma centre resulted in a 17.63% increase in the number of trauma patients. The integration of advanced practice nurses (APN) into the trauma care system led to significant improvements in time‐efficiency indicators, with the exception of advanced airway establishment time (p

Abstract Background There is an increasing prevalence of cardiovascular disease (CVD) in China, which represents the leading cause of mortality. Precise CVD risk identification is the fundamental prevention component. This study sought to systematically review the CVD risk prediction models derived and/or validated in the Chinese population to promote primary CVD prevention. Methods Reports were included if they derived or validated one or more CVD risk prediction models in the Chinese population. PubMed, Embase, CINAHL, Web of Science, Scopus, China National Knowledge Infrastructure (CNKI), VIP database, etc., were searched. The risk of bias was assessed with the Prediction Model Risk of Bias Assessment Tool (PROBAST). Meta-analysis was performed in R using the package metamisc. Results From 55,183 records, 22 studies were included. Twelve studies derived 18 CVD risk prediction models, of which seven models were derived based on a multicentre cohort including more than two provinces of mainland China, and one was a model developed based on a New Zealand cohort including Chinese individuals. The number of predictors ranged from 6 to 22. The definitions of predicted outcomes showed considerable heterogeneity. Fourteen articles described 29 validations of 8 models. The Framingham model and pooled cohort equations (PCEs) are the most frequently validated foreign tools. Discrimination was acceptable and similar for men and women among models (0.60–0.83). The calibration estimates changed substantially from one population to another. Prediction for atherosclerotic cardiovascular disease Risk in China (China-PAR) showed good calibration [observed/expected events ratio = 0.99, 95% PI (0.57,1.70)] and female sex [1.10, 95% PI (0.23,5.16)]. Conclusions Several models have been developed or validated in the Chinese population. The usefulness of most of the models remains unclear due to incomplete external validation and head-to-head comparison. Future research should focus on externally validating or tailoring these models to local settings. Trail registration This systematic review was registered at PROSPERO (International Prospective Register of Systematic Reviews, CRD42021277453).

Background: Ethical conflict is embedded in healthcare and is common in critical care setting. However, there is a paucity of research on the nature of ethical conflict in China. Ethical conflict has cultural and context sensitivity. Therefore, evidence is needed from different backgrounds to help discuss this issue across borders. Aim: This study aimed to qualitatively identify the experience of ethical conflict in critical care professionals in China. Study design: From December 2021 to February 2022, we performed semi‐structured, face‐to‐face interviews with 21 critical care professionals from five intensive care units in a tertiary general hospital in China. A thematic analysis approach was used to analyse the data. Results: Five themes and 14 sub‐themes emerged from the data. Critical care professionals probably felt unable to navigate uncertainty, torn by family issues, outraged by unprofessional behaviours of medical staff, being trapped in a socioeconomic dilemma when having experience of ethical conflict. In addition, they also perceived that they could turn struggle into growth. Conclusions: The experience of ethical conflict in critical care professionals involved a mixture of feelings. This study builds a comprehensive understanding of how ethical conflict affected their perceptions of themselves and their profession and provides implications to develop effective coping strategies. Relevance to Clinical Practice: The identification of critical care professionals' experience of ethical conflict would help identify what might trigger the ethical issues and what would be the potential target to optimize in critical practice. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The purpose of this paper was to clarify the concept of ethical conflict in nursing and highlight the importance of tackling this issue. Background: Ethical conflict is on the rise in the nursing context. It is associated with the compromise of nurses' well‐being and patient care. However, there is no thorough conceptual understanding of this concept. Design: Concept analysis. Methods: Databases (PubMed, PsycINFO, CINAHL, Scopus, Embase, Web of Science and SocINDEX) were searched for studies between 1984 and 2021. Both quantitative and qualitative studies related to ethical conflict in nursing were included. Walker and Avant's method of concept analysis was used to identify the defining attributes, antecedents and consequences of the concept of ethical conflict in nursing. We followed the PRISMA‐ScR checklist to report the study. Results: Thirty studies were included for conceptualization. Defining attributes were divided into four categories: (1) emotional responses, (2) incompatible values, (3) competing interests and (4) ambiguous obligations. The antecedents were (1) ethical sensitivity, (2) negative ethical climate, (3) insufficient authority, (4) unrealistic expectations, (5) poor collaboration and (6) inadequate resources. The consequences were identified as (1) moral residue, (2) loss of identity, (3) professional burnout and (4) poor patient care. Conclusions: A unified conceptual model of ethical conflict in nursing shed light on the ethical issues nurses might come across in practice. Despite the fact that ethical conflict is inherently negative, we conceptualised this concept as a neutral fact and an opportunity for nursing action. The construct identification provides basis for both the development of practice and the development of staff support and education. Relevance to Clinical Practice: A clearer understanding of such an important facet of nursing practice helps nurses raise awareness of ethical conflict and implement effective coping strategies to improve their well‐being and patient care. No Patient or Public Contribution: This is a review article conducted by the researchers, so there is no patient or public contribution. [ABSTRACT FROM AUTHOR]