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Background: Recent studies provide compelling evidence linking the gut microbiota to most cancers. Nevertheless, further research is required to establish a definitive causal relationship between the gut microbiota and malignant cardiac tumors., Methods: The genome-wide association studies (GWAS) data on the human gut Microbiota, included in the IEU Open GWAS project, was initially collected by the MiBioGen consortium. It encompasses 14,306 individuals and comprises a total of 5,665,279 SNPs. Similarly, the GWAS data on malignant cardiac tumors, also sourced from the IEU Open GWAS project, was initially stored in the finnGen database, including 16,380,303 SNPs observed within a cohort of 174,108 individuals within the European population. Utilizing a two-sample Mendelian randomization (MR) methodology, we examined whether there exists a causal association between the gut microbiota and cardiac tumors. Additionally, to bolster the credibility and robustness of the identified causal relationships, we conducted an extensive array of sensitivity analyses, encompassing Cochran's Q test, MR-PRESSO tests, MR-Egger interpret test, directionality test and leave-one-out analysis., Results: Our analysis unveiled seven distinct causal associations between genetic susceptibility in the gut microbiota and the incidence of malignant cardiac tumors. Among these, the Family Rikenellaceae, genus Eubacterium brachy group, and genus Ruminococcaceae UCG009 exhibited an elevated risk of cardiac tumors, while the phylum Verrucomicrobia, genus Lactobacillus, genus Ruminiclostridium5, and an unknown genus id.1868 were genetically linked to a reduced risk of cardiac tumors. The causal relationship between these two bacteria, belonging to the phylum Verrucomicrobia (OR = 0.178, 95% CI: 0.052-0.614, p = 0.006) and the genus Ruminococcaceae UCG009 (OR = 3.071, 95% CI: 1.236-7.627, p = 0.016), and cardiac tumors was further validated through sensitivity analyses, reinforcing the robustness and reliability of the observed associations., Conclusion: Our MR analysis confirms that the phylum Verrucomicrobia displays significant protection against cardiac tumor, and the genus Ruminococcaceae UCG009 leads to an increasing risk of cardiac tumor., (© 2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.)

Competing Interests: Competing interests: None declared.

Background and Aim: The relationship between appendicular lean mass (ALM) and most cardiovascular events has been established, but the direct association between ALM and atrial fibrillation (AF) remains uncertain., Methods and Results: Herein, we identified 494 single-nucleotide polymorphisms (SNPs) strongly associated with ALM as instrumental variables (P < 5E-8) based on a genome-wide association study (GWAS) with 450,243 European participants. Then, we employed five Mendelian randomization (MR) analysis methods to investigate the causal relationship between ALM and AF. All results indicated a causal relationship between ALM and AF, among Inverse variance weighted (P = 8.44E-15, odds ratio [OR]: 1.16, 95 % confidence interval [CI]: 1.114-1.198). Furthermore, we performed a sensitivity analysis, which revealed no evidence of pleiotropy (egger&#95;intercept = 0.000089, P = 0.965) or heterogeneity (MR Egger, Q Value = 0.980; Inverse variance weighted, Q Value = 0.927). The leave-one-out method demonstrates that individual SNPs have no driven impact on the whole causal relationship. Multivariable MR analysis indicates that, after excluding the influence of hypertension and coronary heart disease, a causal relationship between ALM and AF still exists (P = 7.74E-40, OR 95 %CI: 1.389 (1.323-1.458)). Importantly, the Radial MR framework analysis and Robust Adjusted Profile Score (RAPS) further exhibit the robustness of this causal relationship., Conclusion: A strong association between ALM and AF was confirmed, and high ALM is a risk factor for AF., Competing Interests: Declaration of competing interest The authors declared no potential conflicts of interest with respect to the research, author-ship, and/or publication of this article., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

A dual-signal optical sensing platform was successfully developed for the determination of ascorbic acid (AA) based on blue fluorescent carbon dots (CDs) and manganese dioxide nanosheets (MnO 2 NSs) with strong Tyndall effect (TE) scattering and fluorescence quenching capabilities. In this nanosystem, CDs-MnO 2 NS composites were employed as probes to evaluate the AA concentration. Owing to the strong reduction, the presence of the target AA could reduce the MnO 2 NSs to Mn 2+ and induce the degradation of the MnO 2 NSs, resulting in a significant decrease in the TE scattering intensity of the MnO 2 NSs and the fluorescence recovery of the CDs. Therefore, a novel optical sensor based on TE scattering and fluorescence dual detectors was developed for the sensitive determination of AA. Under optimized conditions, the limits of detection (LODs) of the two modes were 113 and 3 nM, respectively. Furthermore, the dual-signal optical sensing platform was successfully applied for the detection of AA in human serum., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Background: Unit nurse managers hold essential positions that can facilitate implementation of evidence-based practice. Studies showed that nurse managers in China lacked competencies and behaviours necessary to lead evidence-based practice implementation. The aim of the current study was to develop a context-fit training program prototype to enhance leadership competencies and behaviours regarding evidence-based practice implementation of Chinese unit nurse managers., Method: We used a descriptive qualitative study design and followed the integrated knowledge translation approach to co-develop the prototype in a tertiary hospital in Changsha, China. Seven nurse managers from the participated hospital and a researcher co-developed the prototype based on the Ottawa Model of Implementation Leadership (O-MILe). The development process encompassed four phases from November 2021 to March 2022 that involved group discussions (n = 4) and individual interviews (n = 21). All data were analysed by two independent researchers using the thematic analysis method., Results: Managers agreed that all O-MILe behaviours were important to evidence-based practice implementation, and only minor modifications were needed for clarification and adaptation. The actions managers identified that could operationalize the leadership behaviours were related to current clinical practices, evidence-based practice, nurses, patients, interprofessional staff members, incentives and resources, organization and external entities. Three types of general competencies related to evidence-based practice, professional nursing, and implementation leadership were identified. Multimodal activities such as lectures, experience sharing, group discussions, plan development and coaching were suggested to deliver the training program., Conclusions: All O-MILe leadership behaviours were perceived as essential for unit nurse managers to lead EBP implementation in the hospital context in China. We identified the leadership actions and the competencies required for nursing managers to implement EBP in China. Further studies are required to evaluate the acceptability and impact of this prototype. Further studies with large sample sizes across various clinical settings are needed to facilitate the generalization of the findings and gain an in-depth understanding of the program., (© 2024. The Author(s).)

The challenge posed by opioid overdose has become a significant concern for health systems due to the complexities associated with drug prohibition, widespread clinical use, and potential abuse. In response, healthcare professionals have primarily concentrated on mitigating the hallucinogenic and respiratory depressant consequences of opioid overdose to minimize associated risks. However, it is crucial to acknowledge that most opioids possess the capacity to prolong the QT interval, particularly in cases of overdose, thereby potentially resulting in severe ventricular arrhythmias and even sudden death if timely intervention is not implemented. Consequently, alongside addressing the typical adverse effects of opioids, it is imperative to consider their cardiotoxicity. To enhance comprehension of the correlation between opioids and arrhythmias, identify potential targets for prompt intervention, and mitigate the hazards associated with clinical utilization, an exploration of the interaction between drugs and ion channels, as well as their underlying mechanisms, becomes indispensable. This review primarily concentrates on elucidating the impact of opioid drugs on diverse ion channels, investigating recent advancements in this domain, and attaining a deeper understanding of the mechanisms underlying the prolongation of the QT interval by opioid drugs, along with potential interventions., (© 2024. The Author(s).)

Polyether ether ketone (PEEK) is esteemed as a high-performance engineering polymer renowned for its exceptional mechanical properties and thermal stability. Nonetheless, the majority of polymer-based lubricating materials fail to meet the contemporary industrial demands for motion components regarding high speed, heavy loading, temperature resistance, and precise control. Utilizing 3D printing technology to design and fabricate intricately structured components, developing high-performance polymer self-lubricating materials becomes imperative to fulfill the stringent operational requirements of motion mechanisms. This study introduces a novel approach employing 3D printing technology to produce PEEK with varying filling densities and conducting in situ synthesis of zeolitic imidazolate framework (ZIF-8) nanomaterials on its surface to enhance PEEK's frictional performance. The research discusses the synthetic methodology, characterization techniques, and tribological performance evaluation of in situ synthesized ZIF-8 nanomaterials on PEEK surfaces. The findings demonstrate a significant enhancement in frictional performance of the composite material under low-load conditions, achieving a minimum wear rate of 4.68 × 10 -6 mm 3 /N·m compared to the non-grafted PEEK material's wear rate of 1.091 × 10 -5 mm 3 /N·m, an approximately 1.3 times improvement. Detailed characterization and analysis of the worn surface of the steel ring unveil the lubrication mechanism of the ZIF-8 nanoparticles, thereby presenting new prospects for the diversified applications of PEEK.

Background: Despite being a global public health concern, there is a research gap in analyzing implementation strategies for managing off-label drug use in children. This study aims to understand professional health managers' perspectives on implementing the Guideline in hospitals and determine the Guideline's implementation facilitators and barriers., Methods: Pediatric directors, pharmacy directors, and medical department directors from secondary and tertiary hospitals across the country were recruited for online interviews. The interviews were performed between June 27 and August 25, 2022. The Consolidated Framework for Implementation Research (CFIR) was adopted for data collection, data analysis, and findings interpretation to implement interventions across healthcare settings., Results: Individual interviews were conducted with 28 healthcare professionals from all over the Chinese mainland. Key stakeholders in implementing the Guideline for the Management of Pediatric Off-Label Use of Drugs in China (2021) were interviewed to identify 57 influencing factors, including 27 facilitators, 29 barriers, and one neutral factor, based on the CFIR framework. The study revealed the complexity of the factors influencing managing children's off-label medication use. A lack of policy incentives was the key obstacle in external settings. The communication barrier between pharmacists and physicians was the most critical internal barrier., Conclusion: To our knowledge, this study significantly reduces the implementation gap in managing children's off-label drug use. We provided a reference for the standardized management of children's off-label use of drugs., (© 2024. The Author(s).)

Background: Due to the diversity and high sensitivity of the treatment, there were difficulties and uncertainties in the breast cancer surgical decision-making process. We aimed to describe the patient's decision-making behaviour and shared decision-making (SDM)-related barriers and facilitators in breast cancer surgical treatment., Methods: We searched eight databases for qualitative studies and mixed-method studies about breast cancer patients' surgical decision-making process from inception to March 2021. The quality of the studies was critically appraised by two researchers independently. We used a 'best fit framework approach' to analyze and synthesize the evidence., Results: Twenty-eight qualitative studies and three mixed-method studies were included in this study. Four themes and 10 subthemes were extracted: (a) struggling with various considerations, (b) actual decision-making behaviours, (c) SDM not routinely implemented and (d) multiple facilitators and barriers to SDM., Conclusions: Patients had various considerations of breast surgery and SDM was not routinely implemented. There was a discrepancy between information exchange behaviours, value clarification, decision support utilization and SDM due to cognitive and behavioural biases. When individuals made surgical decisions, their behaviours were affected by individual-level and system-level factors. Therefore, healthcare providers and other stakeholders should constantly improve communication skills and collaboration, and emphasize the importance of decision support, so as to embed SDM into routine practice., Patient and Public Contribution: This systematic review was conducted as part of a wider research entitled: Breast cancer patients' actual participation roles in surgical decision making: a mixed method research. The results of this project helped us to better analyze and generalize patients' views., (© 2024 The Authors. Health Expectations published by John Wiley & Sons Ltd.)

Objectives: To comprehensively synthesise evidence regarding the validity and reliability of the Anaesthetists' Non-Technical Skills (ANTS) behavioural marker system and its application as a tool for the training and assessment of non-technical skills to improve patient safety., Design: Systematic review., Data Sources: We employed a citation search strategy. The Scopus and Web of Science databases were searched for articles published from 2002 to May 2022., Eligibility Criteria: English-language publications that applied the ANTS system in a meaningful way, including its use to guide data collection, analysis and reporting., Data Extraction and Synthesis: Study screening, data extraction and quality assessment were performed by two independent reviewers. We appraised the quality of included studies using the Joanna Briggs Institute Critical Appraisal Checklists. A framework analysis approach was used to summarise and synthesise the included articles., Results: 54 studies were identified. The ANTS system was applied across a wide variety of study objectives, settings and units of analysis. The methods used in these studies varied and included quantitative (n=42), mixed (n=8) and qualitative (n=4) approaches. Most studies (n=47) used the ANTS system to guide data collection. The most commonly reported reliability statistic was inter-rater reliability (n=35). Validity evidence was reported in 51 (94%) studies. The qualitative application outcomes of the ANTS system provided a reference for the analysis and generation of new theories across disciplines., Conclusion: Our results suggest that the ANTS system has been used in a wide range of studies. It is an effective tool for assessing non-technical skills. Investigating the methods by which the ANTS system can be evaluated and implemented for training within clinical environments is anticipated to significantly enhance ongoing enhancements in staff performance and patient safety., Prospero Registration Number: CRD42022297773., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Observational studies have suggested that immune-mediated inflammatory diseases (IMIDs) are associated with a higher risk of valvular heart disease (VHD). But the potential causal association is not clear. Therefore, we used Mendelian randomization (MR) analysis to assess the causal association of IMIDs with VHD risk., Methods: A two-sample MR analysis was performed to confirm the causal association of several common IMIDs (systemic lupus erythematosus, SLE; rheumatoid arthritis, RA; multiple sclerosis, MS; ankylosing spondylitis, AS; psoriasis, PSO; inflammatory bowel disease, IBD) with the risk of VHD. The exposure data is derived from published genome-wide association studies (GWASs) and outcome data come from the FinnGen database (47,003 cases and 182,971 controls). Inverse-variance weighted (IVW), MR-Egger, and weighted median methods were performed to assess the causal association. The study design applied univariable MR and multivariable MR., Results: The MR analysis indicated that several genetically predicted IMIDs increased the risk of VHD, including SLE (odds ratio (OR) = 1.014; 95% confidence interval (CI) =  < 1.001,1.028 > ; p = 0.036), RA (OR = 1.017; 95% CI =  < 1.002,1.031 > ; p = 0.025), and IBD (OR = 1.018; 95% CI =  < 1.002,1.033 > ; p = 0.023). Multivariable MR indicated that the adverse effect of these IMIDs on VHD was dampened to varying degrees after adjusting for smoking, obesity, coronary artery disease, and hypertension., Conclusion: Our findings support the first genetic evidence of the causality of genetically predicted IMIDs with the risk of developing into VHD. Our results deliver a viewpoint that further active intervention needs to be explored to mitigate VHD risk in patients with SLE, RA, and IBD. Key Points • Genetically predicted systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and inflammatory bowel disease (IBD) are causally associated with valvular heart disease (VHD). • To reduce the risk of VHD in patients with SLE, RA, and IBD, active interventions should be further explored., (© 2023. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).)

Neuroblastoma is one of the most common tumors in children. Cases where an isolated soft-tissue metastasis mass is the initial symptom are rare, with only four such cases reported to date. We describe the imaging findings of ten cases of neuroblastoma patients in our hospital with superficial soft tissue mass (SSTM) as the primary symptom. The main ultrasound finding of SSTM was hypoechoic masses or scattered speck-like hyperechoic masses. However, when this type of SSTM is caused by soft tissue metastasis, the location is often atypical, and ultrasound findings are difficult to distinguish from other benign diseases. Therefore, this research should remind clinicians to recognize atypical presentations of this common childhood malignant tumor. Radiologists should also consider the possibility of neuroblastoma when finding this type of SSTM with atypical ultrasound features.

Background: Peripheral neuropathy (PN) is prevalent in people with human immunodeficiency virus (PHIV) with no Food and Drug Administration-approved treatment. Therapeutic Chinese massage (TCM) is a promising noninvasive and non-harmful intervention for HIV-related PN. However, relevant research is lacking. The purpose of this study is to evaluate the feasibility of TCM for HIV-related PN., Method: We conducted a pilot, single-centered, two-arm, double-blinded, randomized controlled trial. Twenty eligible PHIV were recruited primarily from the AIDS Foundation Houston, Inc. in Texas and were randomly assigned into two groups. Ten participants in the intervention group received three weekly 25-min TCM sessions by a certified TCM therapist. The remaining ten control group participants received the same therapist's three weekly 25-min placebo massage sessions on their lower extremities. The outcome was the feasibility of this study as measured by recruitment and completion rates, participant safety, and treatment adherence and compliance, as well as the effect size of the intervention., Results: The study population comprised 20 PHIV (mean age 55.23). This study showed high feasibility as measured by a high rate of recruitment, a 100% rate of completion, and zero serious adverse events. As we inquired 21 respondents for eligibility for the study, all except one had HIV-related PN. All respondents were willing to participate in the study and adhered to the group assignment after they enrolled in the study. The participants' baseline pain was at a medium to a high level (6.30 [2.15] out of 10)., Conclusion: Chinese massage is a feasible intervention in PHIV. Future relevant randomized controlled trials are expected., Clinical Trial Registration: https://clinicaltrials.gov/, NCT05379140., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Ge, Dune, Liu, Fu, Ma, Hu, Lin and Li.)

Owing to environmental concerns, microplastics pollution has been the object of increasing attention. Currently, the chemical composition of microplastics is commonly detected using Raman spectroscopy. Nevertheless, the Raman spectra of microplastics may be overlaid by signals derived from additives (e.g., pigment), resulting in serious interference. In this study, an efficient method is proposed to overcome the interference of fluorescence during Raman spectroscopic detection of microplastics. Four catalysts of Fenton's reagent (Fe 2+ , Fe 3+ , Fe 3 O 4 , and K 2 Fe 4 O 7 ) have been investigated for their capacity to generate hydroxyl radical (•OH), thus potentially eliminating the fluorescent signals in microplastics. The results indicate that the Raman spectrum of microplastics treated with Fenton's reagent can be efficiently optimized in the absence of spectral processing. This method has been successfully applied to the detection of microplastics collected from mangroves, featuring a range of colours and shapes. Consequentially, after 14 h of treatment with sunlight-Fenton (Fe 2+ : 1 × 10 -‍6 M, H 2 O 2 : 4 M), the Raman spectra matching-degree (RSMD) of all microplastics were >70.00 %. The innovative strategy discussed in this manuscript can greatly promote the application of Raman spectroscopy in the detection of real environmental microplastics, overcoming interfering signals derived from additives., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

Background: There are strong recommendations and high demand for the use of holistic admission review (HAR). However, there is no study exploring and identifying barriers and facilitators to implementing HAR in health care education programs., Method: This qualitative descriptive study aimed to understand the key determinants influencing the integration of HAR in graduate advanced nursing programs. Two online focus groups with content analysis were used to identify barriers and facilitators., Results: The findings highlight 39 key determinants of HAR implementation in the graduate advanced nursing program; the determinants included four neutral influencing factors, 18 barriers, and 17 facilitators. These influencing factors aligned with all four domains in the Consolidated Framework for Implementation Research (CFIR) and with 20 of the 39 CFIR constructs., Conclusion: By taking into account the facilitators and barriers, graduate advanced nursing programs may use effective implementation strategies to integrate HAR changes and guide their evolving admissions processes. [ J Nurs Educ . 2023;62(10):570-574.] .

Strain rate and temperature are influential factors that significantly impact the mechanical properties of long glass fiber-reinforced polypropylene composites. This study aims to investigate the tensile properties of these composites, analyzing the effects of temperature, strain rate, and their interplay on variables such as tensile stress, tensile strength, fracture stress, and fracture morphology through a series of comprehensive tensile experiments. The experimental results demonstrate a notable increase in both tensile strength and tensile fracture stress when the temperature is set at 25 °C, accompanied by strain rates of 10 -4 , 10 -3 , 10 -2 , and 10 -1 s -1 . Conversely, a significant decrease is observed in the aforementioned properties when the strain rate is fixed at 10 -4 , while varying temperatures of -25 °C, 0 °C, 25 °C, 50 °C, and 75 °C are applied. At lower temperatures, cracks manifest on the fracture surface, while matrix softening occurs at higher temperatures. Additionally, in the context of strain rate-temperature coupling, the decreasing trend of both tensile strength and tensile fracture stress decelerates as the temperature ranges from -25 °C to 75 °C at a strain rate of 10 -1 , compared to 10 -4 s -1 . These findings highlight the significant influence of both strain rate and temperature on high fiber content long glass fiber-reinforced polypropylene composites.

Objective: To understand developers' perception of patient (versions of) guidelines (PVGs), and identify challenges during the PVG development, with the aim to inform methodological guidance for future PVG development., Methods: We used a descriptive qualitative design. Semi-structured interviews were conducted virtually from December 2021 to April 2022, with a purposive sampling of 12 PVG developers from nine teams in China. Conventional and directed content analysis was used for data analysis., Results: The interviews identified PVG developers' understanding of PVGs, their current practice experience, and the challenges of developing PVGs. Participants believed PVGs were a type of health education material for patients; therefore, it should be based on patient needs and be understandable and accessible. Participants suggested that PVGs could be translated/adapted from one or several clinical practice guidelines (CPG), or developed de novo (i.e., the creation of an entirely new PVG with its own set of research questions that are independent of existing CPGs). Participants perceived those existing methodological guidelines for PVG development might not provide clear instructions for PVGs developed from multiple CPGs and from de novo development. Challenges to PVG development include (1) a lack of standardized and native guidance on developing PVGs; (2) a lack of standardized guidance on patient engagement; (3) other challenges: no publicly known and trusted platform that could disseminate PVGs; concerns about the conflicting interests with health professionals., Conclusions and Practice Implications: Our study suggests clarifying the concept of PVG is the primary task to develop PVGs and carry out related research. There is a need to make PVG developers realize the roles of PVGs, especially in helping decision-making, to maximize the effect of PVG. It is necessary to develop native consensus-based guidance considering developers' perspectives regarding PVGs., (© 2023. The Author(s).)

Despite known analgesic effects of breastfeeding (BF), skin-to-skin care (SSC), and sweet solutions (sucrose) for newborns, these interventions remain underutilized. Our team produced a five-minute parent-targeted video (BSweet2Babies) demonstrating BF, SSC, and sucrose during newborn blood sampling. We conducted a sequential exploratory mixed-methods study with eight maternal-newborn units across Ontario, Canada to identify barriers and facilitators to implementing the video and the three pain management strategies.Over a 6-month period, data collection included 15 telephone interviews, two email communications, and three community of practice teleconferences with the participating sites ( n = 8). We used the Theoretical Domains Framework as the coding matrix. Participants discussed integrating the video in prenatal education and the importance of involving leadership when planning for practice change. Key barriers included lack of comfort with parental presence, perception of high complexity of the strategies, short postpartum stays, competing priorities, and interprofessional challenges. Key facilitators included alignment with the Baby-Friendly Hospital Initiative, modeling by Lactation Consultants, and frequent reminders.

Purpose: To modify and translate the Parents' Perceptions of Satisfaction with Care from Pediatric Nurse Practitioners instrument into Chinese, culturally adapt and initially test it to assess parental satisfaction with care from all levels of pediatric nurses in a pediatric inpatient care context., Design and Methods: The instrument was translated and culturally adapted following a standardized guideline for the translation and cross-cultural adaptation of self-report measures. Content validity, discriminative validity, internal consistency and test-retest reliability were examined., Results: Four main issues were identified in the translation and cultural adaptation stage. Modifications were therefore made to the Chinese Parents' Perceptions of Satisfaction with Care from Pediatric Nurses instrument. The item-level content validity indexes for the Chinese instrument ranged between 0.83 and 1.0. The Cronbach's alpha coefficient was 0.95, and the intra-class correlation coefficient for test-retest reliability was 0.44., Conclusion: The Chinese Parents' Perceptions of Satisfaction with Care from Pediatric Nurses instrument has good content validity and internal consistency and can be considered a suitable clinical evaluation tool to measure parental satisfaction with care from pediatric nurses in pediatric inpatient settings in China., Practice Implications: The instrument is anticipated to be useful in strategic planning for Chinese nurse managers responsible for patient safety and quality of care. Additionally, it has the potential to serve as a tool to enable international comparisons in parental satisfaction with care from pediatric nurses after further testing., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflicts of interest., (Copyright © 2023. Published by Elsevier Inc.)

Background: Although theoretical frameworks exist to guide social media interventions, few of them make it explicit how social media is supposed to work to improve the knowledge use by health care providers. This study aimed to synthesize literature to understand how and under what circumstances social media supports knowledge use by health care providers in clinical practice. Methods: We followed the realist review methodology described by Pawson et al. It involved six iterative steps: (1) develop an initial program theory; (2) search for evidence; (3) select and appraise studies; (4) extract data; (5) synthesize data; and (6) draw conclusions. Results: Of the 7,175 citations retrieved, 32 documents were prioritized for synthesis. We identified two causal explanations of how social media could support health care providers' knowledge use, each underpinned by distinct context-mechanism-outcome (CMO) configurations. We defined these causal explanations as: (1) the rationality-driven approach that primarily uses open social media platforms ( n  = 8 CMOs) such as Twitter, and (2) the relationality-driven approach that primarily uses closed social media platforms ( n  = 6 CMOs) such as an online community of practice. Key mechanisms of the rationality-driven approach included social media content developers capabilities and capacities, in addition to recipients' access to, perceptions of, engagement with, and intentions to use the messages, and ability to function autonomously within their full scope of practice. However, the relationality-driven approach encompassed platform receptivity, a sense of common goals, belonging, trust and ownership, accessibility to expertise, and the fulfillment of needs as key mechanisms. Conclusion: Social media has the potential to support knowledge use by health care providers. Future research is necessary to refine the two causal explanations and investigate their potential synergistic effects on practice change.

Due to the diversified and high sensitivity of breast cancer surgical treatment, various decision making styles show different functions in making trade-offs and sharing information. Shared decision making is the best practice paradigm to promote health outcomes. This study aimed to determine the overall frequency of shared decision making and explore influencing factors during the surgical decision-making process from breast cancer patients' perspectives. We searched 8 databases for studies about breast cancer patients' surgical decisional control preferences and shared decision making preference. Two researchers screened the literature, extracted the data, and evaluated the literature quality. Meta-analysis of the frequency of preferred and actual shared decision making and decision congruence was performed. Due to the limited studies of influencing factors, descriptive analysis was used. Fourteen original studies were included in this study. We found the overall pooled frequency of the preferred shared decision making of 48.1% (95%CI 33.5%, 62.6%) and the actual shared decision making of 38.1% (95%CI 33.9%, 42.2%). Moreover, the pooled frequency of the decision congruence between preferred and actual decision styles was 61.7% (95%CI 54.6%, 68.8%). The descriptive analysis findings indicated that the influencing factors of shared decision making included individual factors, surgeon-patient communication factors, and health setting factors. There was a gap between the preferred and actual decision styles in the surgical context. Therefore, health care providers should identify potential shared decision making barriers and facilitators, and advocate the clinical shared decision making model to embed shared decision making into routine practice., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background: An increasing number of interventions have focused on leadership development for healthcare managers, among which coaching is a common strategy. The purpose of the present systematic review is to synthesize evidence on the effect of coaching in developing leadership of healthcare managers., Methods and Analysis: A literature search will be conducted in six English databases (MEDLINE (Ovid), CINAHL, Embase, Cochrane library, Nursing & Allied Health Premium, and Scopus) and four Chinese databases (Wanfang, CNKI, SinoMed, and VIP) from inception to April 1st, 2022. The titles, abstracts, and full texts of the studies will be screened by two independent researchers to determine their eligibility. The RoB 2, ROBINS-I, CASP, and MMAT will be applied to assess the quality of randomized trials, non-randomized studies, qualitative studies, and mixed-method studies, respectively. We will then extract the study characteristics, participant characteristics, and study outcomes of the reviewed papers. The Aims, Ingredients, Mechanism, and Delivery framework will be used to extract the components of coaching strategies. For quantitative data, a meta-analysis will be performed if sufficient data are available; otherwise, we will conduct a narrative synthesis. Thematic synthesis methods will be used for qualitative data analysis., Discussion: By conducting this systematic review, we expect to synthesize evidence regarding the components of coaching for leadership development among healthcare managers; the influence of coaching on leadership development among managers at the individual, unit-wide, or organizational level; and how managers view coaching as a leadership development strategy., Trial Registration: PROSPERO registration number: CRD42020194290 ., (© 2022. The Author(s).)

Background: Enteral tube feeding is commonly used in preterm infants to provide enteral nutrition. Nurses play a crucial role in promoting feeding safety and performance., Objectives: The aims of this systematic review were to identify nursing practices regarding feeding safety and performance promotion in preterm infants with enteral tube feeding and summarize evidence on the effectiveness of these practices., Methods: A comprehensive search was performed in six databases (MEDLINE, EMBASE, CINAHL, Web of Science, Cochrane Library, and Scopus). Studies on nursing practices aimed at promoting feeding safety and performance in preterm infants with enteral tube feeding were included. Risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials (RoB 2) for randomized controlled studies and the tool of risk-of-bias in non-randomized studies of interventions (ROBINS-I) for non-randomized studies of interventions. A narrative synthesis strategy was employed to gather evidence and analyze data., Results: 61 studies (47 randomized controlled studies and 14 quasi-experimental studies) covering seven categories of practices were included. The identified nursing practices included controlling feeding interval, selecting feeding position, monitoring gastric residual, disposing of gastric residual, managing feeding temperature, feeding promotion stimulation, and supplementary methods during the transition from tube to oral feeding. Evidence supported the effectiveness of oro-motor stimulation and non-nutritive sucking as feeding performance promotion strategies in preterm infants. Other practices were suggested to be used cautiously or recommended to be further studied due to limited evidence., Conclusions: The review identified seven categories of nursing practices in promoting feeding safety and performance in preterm infants receiving enteral tube feeding. Oro-motor stimulation and non-nutritive sucking can be used in clinical settings to promote feeding performance in preterm infants with enteral tube feeding. Other practices will continue to be dictated by local preferences and cost factors until more robust evidence becomes available., Registration: PROSPERO database (CRD42020196256)., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022. Published by Elsevier Ltd.)

Background: Inappropriate health care leads to negative patient experiences, poor health outcomes and inefficient use of resources. We aimed to conduct a systematic review of inappropriately used clinical practices in Canada., Methods: We searched multiple bibliometric databases and grey literature to identify inappropriately used clinical practices in Canada between 2007 and 2021. Two team members independently screened citations, extracted data and assessed methodological quality. Findings were synthesized in 2 categories: diagnostics and therapeutics. We reported ranges of proportions of inappropriate use for all practices. Medians and interquartile ranges (IQRs), based on the percentage of patients not receiving recommended practices (underuse) or receiving practices not recommended (overuse), were calculated. All statistics are at the study summary level., Results: We included 174 studies, representing 228 clinical practices and 28 900 762 patients. The median proportion of inappropriate care, as assessed in the studies, was 30.0% (IQR 12.0%-56.6%). Underuse (median 43.9%, IQR 23.8%-66.3%) was more frequent than overuse (median 13.6%, IQR 3.2%-30.7%). The most frequently investigated diagnostics were glycated hemoglobin (underused, range 18.0%-85.7%, n = 9) and thyroid-stimulating hormone (overused, range 3.0%-35.1%, n = 5). The most frequently investigated therapeutics were statin medications (underused, range 18.5%-71.0%, n = 6) and potentially inappropriate medications (overused, range 13.5%-97.3%, n = 9)., Interpretation: We have provided a summary of inappropriately used clinical practices in Canadian health care systems. Our findings can be used to support health care professionals and quality agencies to improve patient care and safety in Canada., Competing Interests: Competing interests: Alan Katz is a member of the ICES Scientific Advisory Committee and the SAIL International Advisory Board. He is president of the Canadian Association for Health Services and Policy Research and a member of the Board of Directors of The College of Family Physicians Canada. No other competing interests were declared., (© 2022 CMA Impact Inc. or its licensors.)

Background: Evidence-based practice (EBP) implementation plays a crucial role in bridging the knowledge-action gaps and reducing health inequities. Little is known about its development in China. This study aims to provide an overview of the EBP implementation research progress in healthcare in China and identify gaps for future studies., Methods: We conducted a scoping review following the Joanna Briggs Institute scoping review methodology and the Cochrane Collaboration's guidance on living reviews. We performed a literature search in four Chinese databases (i.e., China National Knowledge Infrastructure, Wan Fang Database, The VIP Database, and China Biology Medicine) and three English databases (i.e., Ovid MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, and EMBASE), Google scholar, and Baidu scholar from 1996 to 2021. We included EBP implementation studies conducted in healthcare settings in China and were published in Chinese and English literature. The search will be run on a regular basis to monitor the development of new literature and determine when to update the review., Findings: Of the 11,276 records identified, we finally included 309 papers. The publications were on a sharp rise since 2013 and were predominantly from the nursing field (292/309, 94.50%). The commonly researched areas were symptom management (75/309, 24.27%), tube care (46/309, 14.89%), perioperative care (43/309, 13.92%), and fundamental care (43/309, 13.92%). Joanna Briggs Institute model was the most frequently used model to guide the implementation process (92/159, 59.75%). A median number of 8 people often comprised an implementation team, with 113 studies (36.57%) taking a multidisciplinary approach. 204 studies reported utilizing audit criteria to assist evaluation of evidence implementation rate with diversified methods measuring the criteria. Lack of knowledge, skills, and resources, and incomplete procedures or pathways were top barriers impeding EBP implementation. Leadership support was considered the most common facilitator. Education and training were the most frequently described implementation strategies for healthcare professionals and patients. Optimizing workflows and developing evaluation tools were the primary strategies adopted by organizations. 291 studies measured patient outcomes and 174 studies measured healthcare professional outcomes., Interpretation: To our knowledge, this scoping review is the first one to systematically examine the EBP implementation research progress in healthcare in China. Based on this review, we identified contributions that Chinese EBP implementation research made to the global community, and provided eight recommendations for Chinese researchers in conducting implementation studies in the future., Funding: None., Competing Interests: All authors declare no competing interests., (© 2021 The Authors.)

Aim: This study aimed to evaluate the validity, reliability and acceptability of the Implementation Leadership Scale in the Chinese nursing context., Design: This study utilized a cross-sectional design., Methods: This study was conducted in one general tertiary hospital with 234 nurses (85.3% response rate) from 35 clinical units in China. Content validity, structural validity, convergent validity, reliability (internal consistency), agreement indices and acceptability were evaluated. The data collection was from December 1st, 2017 to June 30th, 2018., Results: Confirmatory factor analysis demonstrated a good model fit to the four-factor implementation leadership model. The psychometric testing also indicated good convergent validity, high internal consistency and acceptable aggregation. Most participants completed the scale in two minutes or less and agreed or strongly agreed that the questions were relevant to implementation leadership, clear and easy to answer., Conclusions: This study demonstrated that the Chinese Implementation Leadership Scale is a valid, reliable and pragmatic tool for measuring strategic leadership for implementing evidence-based practices., (© 2021 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Background: Endotracheal suctioning is one of the most frequently performed invasive procedures by intensive care nurses. Nurses should have adequate knowledge and skills to perform endotracheal suctioning based on the best evidence. Little is known about intensive care nurses' knowledge and practice of evidence-based endotracheal suctioning in Chinese hospitals. The purpose of this study was to investigate intensive care nurses' knowledge and practice of evidence-based recommendations regarding endotracheal suctioning. Specifically, the study aimed to examine (1) intensive care nurses' awareness of and adherence to endotracheal suctioning guidelines and (2) factors influencing their level of awareness and adherence., Methods: A cross-sectional survey of 310 staff nurses working in intensive care units was carried out at Changsha, China. Data on participants' characteristics, awareness of, and adherence to the endotracheal suctioning guidelines were collected through online questionnaires. Following univariate descriptive statistics, the Mann-Whitney U test and Kruskal-Wallis H test were performed using Software Package Statistical Analysis Version 23.0., Results: A total of 281 nurses completed and returned the survey (response rate = 90.6 %). One-half to three-quarters of the nurses knew 21 of the 26 evidence-based practices and believed their practices followed the guidelines. Over half of them were unaware of the difference between open and close suctions and the pros and cons of using hyperinflation. Almost 50 % of nurses believed some of their clinical practices did not follow the evidence-based recommendations, such as not routinely using normal saline and using 80-120 mmHg suction pressure during endotracheal suctioning. Nurses with endotracheal suctioning training demonstrated significantly higher awareness of endotracheal suctioning recommendations and higher adherence levels than untrained nurses., Conclusions: The study findings revealed that Chinese intensive care nurses lacked awareness of several essential evidence-based endotracheal suctioning practices, and there were gaps between their current practice and the guideline recommendations. Further research should emphasize revealing barriers and facilitators of implementing evidence-based endotracheal suctioning practices as well as developing context-suitable interventions for guideline implementation., (© 2021. The Author(s).)

Social media has become a powerful approach to disseminating evidence to knowledge users. The BSweet2Babies video was developed in multiple languages showing the effectiveness of sweet solutions, skin-to-skin care, and breastfeeding during newborn painful procedures. This study aimed to disseminate the BSweet2Babies video in Chinese through social media platform of WeChat in China; evaluate the reach, acceptability, and recommendation of the video; and assess viewers' previous knowledge and experience of using the 3 strategies and intention to use these strategies in the future. Multiple dissemination strategies were used to maximize views for a 6-month dissemination period. The video received 19 812 views, 4306 "thumbs," and 671 participants completed surveys. Of the survey respondents, 393 were parents. Most respondents did not know these strategies and did not use or help parents use any of them. More healthcare professionals than parents intended to use or advocate for sweet solutions and breastfeeding. More healthcare professionals rated that the 3 strategies were easy to apply in real-life situations, but more parents evaluated that the length of the video was too long. Social media in China can be a promising approach to disseminating evidence on neonatal procedural pain treatments to healthcare professionals and the public., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: Whether intraoperative handover of anesthesia care increases the risk of adverse outcomes in patients undergoing surgery remains unclear. This systematic review aimed to synthesize the evidence on the association of intraoperative anesthesia handover with delivery of patient care and patient outcomes., Design: This is a systematic review and meta-analysis., Methods: A comprehensive search was conducted to identify the eligible studies examining the association between intraoperative anesthesia handover and adverse outcomes in patients receiving surgery. The cohort studies and case-control studies were included. The methodological quality of each included study was assessed using the Newcastle-Ottawa Scale. The meta-analysis across the studies was performed using Review Manager. Adjusted odds ratio (aOR) with 95% confidence intervals were used for dichotomous variables. Sensitivity analysis was conducted by removing one study each time and re-estimating the overall effect size., Findings: Seven retrospective cohort studies with 680,155 patients were finally included. Among these participants, 139,362 patients (20.49%) had anesthesia handovers during their surgeries. In pooled analysis, the statistically significant relationship between intraoperative anesthesia handover and composite morbidity was observed (aOR 1.20 and 95% CI 1.12-1.28). However, the number of handovers was not significantly associated with composite of mortality and morbidity (aOR 1.12, 95% CI 1.00-1.25) and in-hospital mortality (aOR 1.26, 95% CI 0.96-1.67)., Conclusions: The findings suggested that each additional intraoperative anesthesia handover increased the odds of composite morbidity. It is important to improve the handover quality and avoid handovers when anesthesia providers have high-risk care events, patients having unstable status, or inadequate handover time., (Copyright © 2020 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.)

Purpose: To explore nurse and physician leaders' perceptions of barriers and facilitators to using evidence-based procedural pain treatments (i.e., sweet solutions, breastfeeding, and topical anesthetics) for hospitalized infants and children in the Chinese context., Design and Methods: A descriptive qualitative study was conducted at three pediatric inpatient surgical units in one hospital in China. Purposive sampling was used to recruit nurse/physician leaders who were engaged in the clinical management of the 3 units. Data collection included a focus group and individual interviews. The Consolidated Framework for Implementation Research (CFIR) was used to guide the analysis of the data., Results: Ten participants attended the focus group and 13 took part in individual interviews. The findings highlight 41 implementation determinants, including two neutral influencing factors, 22 barriers, and 17 facilitators. These influencing factors aligned with the four CFIR domains and 25 of the 29 CFIR constructs. Common barriers to using evidence-based pain treatments across different contexts were identified, such as health care professionals' limited knowledge and misconceptions on pediatric pain management, no specific policies, low priority, heavy workload, staff shortage, and limited time. Unique determinants in the Chinese context were also identified, including parents' concerns of these new interventions, parent wrath, hierarchical managerial system, and lower authority of nurses., Conclusions: Multiple barriers as well as facilitators to using evidence-based pain management strategies were identified., Practice Implications: The findings inform further development of implementation strategies and could be used as baseline data for comparing the barriers and facilitators evaluated during and after implementation., Competing Interests: Declaration of competing interest The authors disclose no conflict of interest., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: This aim of this study was to explore the role of regulation on the quality of care of older people living with depression in LTC, which in this paper is a domestic environment providing 24-h care for people with complex health needs and increased vulnerability., Methods: We conducted a systematic scoping review. A peer reviewed search strategy was developed in consultation with a specialist librarian. Several databases were searched to identify relevant studies including: Embase (using the OVID platform); MEDLINE (using the OVID platform); Psych info (using the OVID platform); Ageline (using the EBSCO platform); and CINHAL (using the EBSCO platform). Articles were screened by three reviewers with conflicts resolved in consultation with authors. Data charting was completed by one reviewer, with a quality check performed by a second reviewer. Key themes were then derived from the included studies., Results: The search yielded 778 unique articles, of which 20 were included. Articles were grouped by themes: regulatory requirements, funding issues, and organizational issues., Conclusion: The highly regulated environment of LTC poses significant challenges which can influence the quality of care of residents with depression. Despite existing evidence around prevalence and improved treatment regimens, regulation appears to have failed to capture the best practice and contemporary knowledge available. This scoping review has identified a need for further empirical research to explore these issues.

Ghost imaging using deep learning (GIDL) is a kind of computational quantum imaging method devised to improve the imaging efficiency. However, among most proposals of GIDL so far, the same set of random patterns were used in both the training and test set, leading to a decrease of the generalization ability of networks. Thus, the GIDL technique can only reconstruct the profile of the image of the object, losing most of the details. Here we optimize the simulation algorithm of ghost imaging (GI) by introducing the concept of "batch" into the pre-processing stage. It can significantly reduce the data acquisition time and create reliable simulation data. The generalization ability of GIDL has been appreciably enhanced. Furthermore, we develop a residual-based framework for the GI system, namely the double residual U-Net (DRU-Net). The imaging quality of GI has been tripled in the evaluation of the structural similarity index by our proposed DRU-Net.

Objectives: Measuring pain in infants is important but challenging, as there is no "gold standard." The measurement of skin conductance (SC) is considered to be a measure of stress and as a surrogate indicator of pain. The objectives of this study were to identify the extent of research conducted and to synthesize the validity evidence of SC for assessing acute pain in infants., Methods: The Arksey and O'Malley framework for scoping reviews was followed, and 9 electronic databases were searched. Data were analyzed thematically and presented descriptively including the following main categories: study information/details, sampling information, characteristics of participants and settings, SC outcome measures, and validity evidence., Results: Twenty-eight studies with 1061 infants were included, including 23 cross-sectional observation studies and 5 interventional studies. The most studied infants were those with mild severity of illness (n=13) or healthy infants (n=12). The validity evidence of SC was tested in relation to referent pain measures (13 variables), stimuli (13 variables), age (2 variables), and other contextual variables (11 variables). SC was not significantly correlated with vital signs, except for heart rate in 2 of the 8 studies. SC was significantly correlated with the unidimensional behavioral pain assessment scales and crying time rather than with multidimensional measurements. Fourteen of 15 studies (93.3%) showed that SC increased significantly during painful procedures., Conclusions: Inconsistent findings on validity of SC exist. Future research should aim to identify the diagnostic test accuracy of SC compared with well-accepted referent pain measures in infants, study the validity evidence of SC in critically ill infants, and utilize rigorous research design and transparent reporting.

Purpose: This study aimed to adapt a guideline for endotracheal suctioning of adults with artificial airways in the perianesthesia setting in China., Design: This study was guided by the ADAPTE framework., Methods: The development process consisted of setup, adaptation, and finalization phases. A heterogeneous consultant panel that included a patient representative was established to contribute guidance and suggestions regarding guideline development. Relevant evidence documents were searched, critically appraised, selected, and synthesized to develop the draft guideline. After revisions, the adapted guideline was evaluated by 20 external reviewers., Findings: A 155-page adapted guideline was developed with 26 key recommendations (including 3 procedure phases and 17 points of care)., Conclusions: The adapted guideline provided the best evidence for endotracheal suctioning of adults with artificial airways and supported practitioner decisions about appropriate endotracheal suctioning practices for this population. The study also lays the groundwork for future projects on quality improvement and knowledge translation., (Copyright © 2018 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.)

Background: Since the completion of the Human Genome Project, health science has been strongly influenced by the advances in genetics and genomics. However, the progress of embracing genetics and genomics into nursing discipline is limited. One of the main barriers is lack of understanding on the relevancy of genetics and genomics to nursing discipline., Objectives: This paper aims to synthesize and develop a theoretical framework for the interaction of nursing discipline with genetics and genomics., Methods: Through content analysis and constant comparative method, a theoretical framework was developed from synthesis of the studies regarding nursing and genetics/genomics indexed in multiple English and Chinese databases., Results: Four main theoretical statements were constructed in the framework: 1) There are three ways to show how genetics and genomics can influence nursing discipline: a new specialty, new technologies and a new lens; 2) The significant contribution of nursing discipline to genetics and genomics lies in how nurses could focus on the association between human responses and genes and how nurses could advocate for their clients in the genetic and genomic era; 3) A paradigm shift occurs after a constant interaction of nursing discipline with genetics and genomics; 4) Implementation strategies could be used to facilitate the integration of genetics and genomics to nursing discipline and advance the paradigm shift., Conclusions: The framework will help to understand the relationship between nursing discipline and genetics and genomics and implicate the future studies integrating genetics and genomic science into nursing discipline.

Regular assessment of risk of violence is shown to be effective in reducing violence in mental health services., Purpose: To evaluate health care providers' use of a violence risk assessment tool on a mental health unit and the facilitators for and barriers to its use., Methods: A descriptive study using the Dillman approach and informed by the Knowledge to Action framework was conducted., Results: Twenty-six health care providers responded to the survey; 62% reported using the violence risk assessment tool available on their unit, but not on a daily basis. Common barriers were lack of knowledge of the tool, lack of resources and time, and negative attitudes toward patients. 42% of participants indicated the need for further training on violence risk assessment., Conclusion: Despite high exposure to violence, health professionals were not conducting daily risk assessments. The barriers and facilitators identified provide direction for interventions that are necessary if the daily use of violence risk assessment tools is to be increased.

Background: Numerous nurses work in operating rooms and recovery rooms or participate in the performance of anaesthesia in China. However, the scope of practice and the education for Chinese Anaesthesia Nurses is not standardized, varying from one geographic location to another. Furthermore, most nurses are not trained sufficiently to provide anaesthesia care., Objectives: This study aimed to develop the first Anaesthesia Nurse Education Program in Mainland China based on the Educational Standards of the International Federation of Nurse Anaesthetists., Methods: The Delphi technique was applied to develop the scope of practice, competencies for Chinese Anaesthesia Nurses and education program. In 2014 the Anaesthesia Nurse Education Program established by the hospital applied for recognition by the International Federation of Nurse Anaesthetists. The Program's curriculum was evaluated against the IFNA Standards and recognition was awarded in 2015., Results: The four-category, 50-item practice scope, and the three-domain, 45-item competency list were identified for Chinese Anaesthesia Nurses. The education program, which was established based on the International Federation of Nurse Anaesthetists educational standards and Chinese context, included nine curriculum modules. In March 2015, 13 candidates received and passed the 21-month education program. The Anaesthesia Nurse Education Program became the first program approved by the International Federation of Nurse Anaesthetists in China., Conclusions: Policy makers and hospital leaders can be confident that anaesthesia nurses graduating from this Chinese program will be prepared to demonstrate high level patient care as reflected in the recognition by IFNA of their adoption of international nurse anaesthesia education standards., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Designed to explore a suitable way to develop nurse anesthetist education in China, this article introduces 3 educational models for nurse anesthesia education in 3 countries, which all are members of the International Federation of Nurse Anesthetists (IFNA). In addition, this article carries out the comparison from 4 areas: program admission requirements; structure and length; content; and delivery mode. Healthcare leaders in China can learn from the United States, France, and the United Kingdom regarding how to develop nurse anesthesia educational programs and how to design a standardized nurse anesthesia educational program, which is consistent with the national need.