Introduction This study explores the preparedness of our emergency department during the COVID-19 outbreak from the nurses’ perspectives, providing a reference and basis for our emergency department’s response to public health emergencies. Methods Using qualitative research methods, semistructured interviews were conducted with 12 emergency nurses who met the inclusion criteria, and Colaizzi analysis was used for data analysis, summary, and induction. Results A cluster of 4 themes that involved preparedness of the emergency department during the COVID-19 outbreak was extracted: organizational preparedness, personal preparedness, patient and family preparedness, and deficiencies and challenges. Discussion Organizations, individuals, patients, and family members were actively prepared to respond to novel coronavirus pneumonia outbreak in the emergency department. The emergency nurses said that the trusted organization guaranteed personal preparedness, and the active cooperation from patients and families was a motivator for personal preparedness. In addition, our study showed that there were deficiencies in both multidisciplinary collaboration efforts and efforts to rapidly diagnose and treat patients with fever in critical condition.

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Background: Studies have shown that manual lymphatic drainage (MLD) has a beneficial effect on lymphedema related to breast cancer surgery. However, whether MLD reduces the risk of lymphedema is still debated. The purpose of this systematic review and meta-analysis was to summarize the current evidence to assess the effectiveness of MLD in preventing and treating lymphedema in patients after breast cancer surgery. Methods: From inception to May 2019, PubMed, EMBASE, and Cochrane Library databases were systematically searched without language restriction. We included randomized controlled trials (RCTs) that compared the treatment and prevention effect of MLD with a control group on lymphedema in breast cancer patients. A random-effects model was used for all analyses. Results: A total of 17 RCTs involving 1911 patients were included. A meta-analysis of 8 RCTs, including 338 patients, revealed that MLD did not significantly reduce lymphedema compared with the control group (standardized mean difference (SMD): −0.09, 95% confidence interval (CI): [−0.85 to 0.67]). Subgroup analysis was basically consistent with the main analysis according to the research region, the publication year, the sample size, the type of surgery, the statistical analysis method, the mean age, and the intervention time. However, we found that MLD could significantly reduce lymphedema in patients under the age of 60 years (SMD: −1.77, 95% CI: [−2.23 to −1.31]) and an intervention time of 1 month (SMD: −1.77, 95% CI: [−2.23 to −1.30]). Meanwhile, 4 RCTs including, 1364 patients, revealed that MLD could not significantly prevent the risk of lymphedema (risk ratio (RR): 0.61, 95% CI: [0.29–1.26]) for patients having breast cancer surgery. Conclusions: Overall, this meta-analysis of 12 RCTs showed that MLD cannot significantly reduce or prevent lymphedema in patients after breast cancer surgery. However, well-designed RCTs with a larger sample size are required, especially in patients under the age of 60 years or an intervention time of 1 month.

CorrespondenceFengying Kang, Resident standardized training central, The First Abstract Aim: This paper explored the general phenomenon and psychological experience of the special background communication in night shift medical staff and provides better reference for night shift communication between doctors and nurses.Background: Physician-nurse communication has always been an important agenda for health care work and an important concept in nursing theory. During night shifts, effective doctor and nurse communication can enhance mutual trust, provide timely and appropriate medical services to patients, reduce adverse events and enhance patient safety.Design: A qualitative study was conducted. Methods:Husserl's descriptive phenomenology method and semi-structured indepth interviews were used to collect data from 8 nurses and 5 doctors. Colaizzi's method was used to analyse data using MAXQDA 12. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was followed (see Appendix S1). Results: Three themes were extracted after sorting out and refining: the need to achieve goals in night-time physician-nurse communication; obstacles in night-time physician-nurse communication; and relationship culture in night-time physiciannurse communication. Conclusion: Attention should be paid to the particularity of night shift and efficiency of achieving the goal of communication between doctors and nurses on night shift, and the hidden obstacles behind communication between doctors and nurses. Managers should pay attention to the cultural construction of night shift communication in the system, form a good night shift communication process and regularly train doctors' and nurses' related communication skills. And they should also study relationship culture rationally to improve the communication efficiency of night shift. Implications for nursing management: The experiences described in this study contribute to a better understanding of obstacles hidden behind night shift physician-nurse communication. This also provides valuable information to professional managers who develop good doctor-nurse relationship culture. K E Y W O R D S communication, night shift, phenomenology, physician-nurse, qualitative study Night shift physician-nurse communication has the characteristics of special time and complicated patient situation. It should emphasize the efficiency of the ultimate goal, target patients' safety and solve their problems timely and appropriately. Foreign literature reports (Young et al., 2012) that the introduction of new night nurses and physician paging systems to reduce the number of non-emergency scenarios could further improve the night communication performance of nurses and doctors as well as ensure patient safety. The study found that the communication process (pre-judgment-handling-communication-solution), communication timing (finding timing, reducing non-emergency calls and focusing on problem-focused reporting) and communication content (doctor-related, disease changes and special sit...

Aim This analysis investigates the concept of violence against nurses by patients and visitors in the emergency department. It aims to differentiate, clarify, and clearly identify this specific concept, which will facilitate more apt measurement and reporting, ultimately to contribute violence reduction measures. Background Due to contextual factors, occupational risk and patient characteristics, violence against nurses by patients and visitors in the emergency department varies from other types of violence against other health care staff. Methods This study employed Walker and Avant's concept analysis technique. Results The analysis found that violence against nurses by patients and visitors in the emergency department is primarily an occurrence of interpersonal violence based on the working relationship, whereby the patient and/or visitor becomes an assailant, and a nurse becomes a target in the absence of capable guardianship. There is also an intentional use of physical force or power, which results in or has a high chance of causing harm. Conclusion A clearer understanding of the antecedents, attributes, and consequences of violence against nurses by patients and visitors arising from this concept analysis provides a framework that will assist in the understanding, measurement, reporting, and prevention of violence and inform future research. Implications for Nursing Management Nursing managers are encouraged to adopt strategies that act on the factors related to attributes and antecedents that will serve to reduce the occurrence of intentional violent acts.