Background Medical device-related pressure injuries(MDRPI) are prevalent and attracting more attention. During ambulance transfer, the shear force caused by braking and acceleration; extensive medical equipment crowed in a narrow space add external risk factors for MDRPIs. However, there is insufficient research on the relationship between MDRPIs and ambulance transfers. This study aims to clarify the prevalence and characteristics of MDRPI during ambulance transfer. Method A descriptive observational study was conducted with convenience sampling. Before starting the study, six PI specialist nurses certified by the Chinese Nursing Association trained emergency department nurses for three MDRPI and Braden Scale sessions, one hour for each session. Data and images of PIs and MDRPIs are uploaded via the OA system by emergency department nurses and reviewed by these six specialist nurses. The information collection begins on 1 July 2022 and ends on 1 August 2022. Demographic and clinical characteristics and a list of medical devices were collected by emergency nurses using a screening form developed by researchers. Results One hundred one referrals were eventually included. The mean age of participants was (58.3±11.69) years, predominantly male (67.32%, n=68), with a mean BMI of 22.48±2.2. The mean referral time among participants was 2.26 ± 0.26 hours, the mean BRADEN score was 15.32 ± 2.06, 53.46% (n=54) of participants were conscious, 73.26% (n=74) were in the supine position, 23.76% (n=24) were in the semi-recumbent position, and only 3 (2.9%) were in the lateral position. Eight participants presented with MDRPIs, and all MDRPIs are stage 1. Patients with spinal injuries are most prone to MDRPIs (n=6). The jaw is the area most prone to MDRPIs, caused by the cervical collar (40%, n=4), followed by the heel (30%, n=3) and nose bridge (20%, n=2) caused by the respiratory devices and spinal board. Conclusion During long ambulance referrals, the prevalence of MDRPIs is higher than in some inpatient settings. The characteristics and related high-risk devices are also different. The prevention of MDRPIs during ambulance referrals deserves more research.

Background The introduction of chest pain centers (CPC) in China has achieved great success in shortening the duration of nursing operations to significantly improve the treatment and outcomes of patients with ST-segment elevation myocardial infarction (STEMI). The nursing handover period is still considered the high incidence period of adverse events because of the distractibility of nurses’ attention, potential interruption, and unclear responsibilities. Under the CPC mechanism, the nursing efficiency and patients’ outcome, whether affected by the nursing handover, is still a knowledge gap in research. This is also the aim of this study. Methods A retrospective study was conducted with data from STEMI patients from a tertiary hospital in the north of Sichuan Province from January 2018 to December 2019 through the Chinese CPC database. Patients are divided into handover and non-handover groups according to the time they presented in the Emergency Department. D2FMC, FMC2FE, FMC2BS, FMC2CBR, FMC2FAD, and D2W were selected to measure nursing efficiency. The occurrence of major adverse cardiovascular events, the highest troponin values within 72 h of hospitalization, and the length of hospitalization were selected to measure the patient outcomes. Continuous variables are summarized as mean ± SD, and t-tests of the data were performed. P-values < 0.05 (two-tailed) were considered statistically significant. Results A total of 231 cases were enrolled, of which 40 patients (17.3%) were divided into the handover period group, and 191 (82.6%) belonged to the non-handover period group. The results showed that the handover period group took significantly longer on items FMC2BS (P < 0.001) and FMC2FAD (P < 0.001). Still, there were no significant differences in D2FMC and FMC2FE, and others varied too little to be clinically meaningful, as well as the outcomes of patients. Conclusion This study confirms that nursing handover impacts the nursing efficiency of STEMI patients, especially in FMC2BS and FMC2FAD. Hospitals should also reform the nursing handover rules after the construction of CPC and enhance the triage training of nurses to assure nursing efficiency so that CPC can play a better role.

Background Medical device-related pressure injuries(MDRPI) are prevalent and attracting more attention. During ambulance transfer, the shear force caused by braking and acceleration; extensive medical equipment crowed in a narrow space add external risk factors for MDRPIs. However, there is insufficient research on the relationship between MDRPIs and ambulance transfers. This study aims to clarify the prevalence and characteristics of MDRPI during ambulance transfer. Method A descriptive observational study was conducted with convenience sampling. Before starting the study, six PI specialist nurses certified by the Chinese Nursing Association trained emergency department nurses for three MDRPI and Braden Scale sessions, one hour for each session. Data and images of PIs and MDRPIs are uploaded via the OA system by emergency department nurses and reviewed by these six specialist nurses. The information collection begins on 1 July 2022 and ends on 1 August 2022. Demographic and clinical characteristics and a list of medical devices were collected by emergency nurses using a screening form developed by researchers. Results One hundred one referrals were eventually included. The mean age of participants was (58.3 ± 11.69) years, predominantly male (67.32%, n = 68), with a mean BMI of 22.48 ± 2.2. The mean referral time among participants was 2.26 ± 0.26 h, the mean BRADEN score was 15.32 ± 2.06, 53.46% (n = 54) of participants were conscious, 73.26% (n = 74) were in the supine position, 23.76% (n = 24) were in the semi-recumbent position, and only 3 (2.9%) were in the lateral position. Eight participants presented with MDRPIs, and all MDRPIs are stage 1. Patients with spinal injuries are most prone to MDRPIs (n = 6). The jaw is the area most prone to MDRPIs, caused by the cervical collar (40%, n = 4), followed by the heel (30%, n = 3) and nose bridge (20%, n = 2) caused by the respiratory devices and spinal board. Conclusion MDRPIs are more prevalent during long ambulance referrals than in some inpatient settings. The characteristics and related high-risk devices are also different. The prevention of MDRPIs during ambulance referrals deserves more research.

Background: The period of nursing handover is still considered the high incidence period of adverse events because of distractibility of nurses’ attention, potential interruption, and unclear responsibilities, although the introduction of chest pain centers (CPC) in China has achieved great success in shortening the duration of nursing operations to significantly improve the treatment and outcomes of patients with ST-segment elevation myocardial infarction (STEMI). However, under the CPC mechanism, the nursing efficiency and patients’ outcome whether affected by the nursing handover is still a knowledge gap in research. This is also the aim of this study. Methods: This retrospective study was conducted with data of STEMI patients from a tertiary hospital in the north of Sichuan Province in the Chinese Mainland from January 2018 to December 2019 through the Chinese CPC database. This hospital is also the largest chest pain center in the region which has 1,200 beds, including 80 emergency beds, and treats over 10,000 emergency patients annually. Then dived data into two groups based on patients’ arrival times. According to the nursing handover schedule of the participating emergency department, patients with STEMI who visited Emergency Department (ED) during the nursing handover were selected in the handover period group (n = 40), and STEMI patients in other periods were included in the non-handover period group (n = 191). Then items were selected for comparison according to relative studies and guidelines. Results: A total of 231 cases were enrolled, of which 40 cases (17.3%) were divided into the handover period group and 191 cases (82.6%) belonged to the non-handover period group. The results showed that the handover period group took significantly longer on items including FMC2BS (P < 0.001), BS2CBR (P = 0.004), CBR2FAD (P < 0.001), and D2W (P = 0.001) compared to the non-handover group, but there were no significant differences in D2FMC and FMC2FE as well as the outcomes of patients. Conclusion: Compared with the non-handover group, the handover group showed a significant delay in important nursing operations in the emergency department. Hospitals should reform relevant regulations for the nursing handover of CPCs to improve the nursing efficiency of patients with STEMI, ensuring better functioning of CPCs.

Background China's PEMS system was established in the 1980s. Due to economic and resource inequalities, China's PEMS system does not have a uniform mode, and regions developed their models based on their circumstances, incorporating North America’s and Europe’s experiences. In the Sichuan PEMS model, when someone calls "120" for a pre-hospital emergency, he/she will first access the Medical Emergency Center, a dispatcher will record the incident information and makes a preliminary judgment, then that information and the judgment will be forwarded to a nearby general hospital, which will send an ambulance staffed by medical workers to provide PEMS. Instead, some people prefer to call hospitals directly for pre-hospital emergencies and communicate directly with medical staff. Which call mode is better has long been a point of contention. Methods This retrospective study included a total of 496 PEMS within 8 km of the participating hospital between 2020 and 2021. Cases that called the Emergency Medical Center dispatcher were classified as "referral group" (n = 318) and cases that called the hospital and communicated directly with medical personnel were classified as "direct group" (n = 178), and appropriate metrics were selected to measure efficiency and information accuracy Results There was no significant difference in the efficiency of PEMS between the two groups, but there was a notable difference in the information accuracy between the two groups on all indicators Conclusion Compared with calling ‘120’, direct PEMS calls to general hospitals have obvious advantages in terms of information accuracy. Perhaps the Emergency Medical Center in Sichuan could try to reform as a supervisory agency for PEMS instead of a dispatch agency or adopt the Shenzhen EMS model where the Emergency Medical Center, after receiving a call for help, transfers the call to the appropriate hospital based on the caller's location and situation, allowing the caller to communicate directly with medical personnel.