International Journal of General Practice Nursing

Construction and Implementation Effect Evaluation of a Hierarchical Training Model for Nurses

Haiying Xu — 2026-03-12

Objective: To construct a scientific and effective hierarchical training model for nurses and systematically evaluate its implementation effect, so as to improve nurses’ professional competence, job satisfaction, and quality of nursing services. Methods: Through literature analysis, Delphi expert consultation, and current situation investigation, a training system targeting nurses at different levels was designed. A quasi-experimental study was conducted, selecting nurses from a Grade A tertiary hospital as research objects, divided into an experimental group (implementing hierarchical training) and a control group (receiving conventional training), with a training cycle of 6 months. Data were collected through multiple dimensions, including questionnaires, theoretical assessments, skill operation evaluations, and nursing quality assessments, and statistical analysis was performed using SPSS 26.0. Results: After the implementation of hierarchical training, the total score of core competencies and scores in all dimensions (such as clinical nursing, professional development, and leadership) of nurses in the experimental group were significantly improved (P<0.05); all indicators of job satisfaction were significantly higher than those in the control group (P<0.01); nursing quality scores and patient satisfaction were also significantly improved (P<0.05). The improvement effect of hierarchical training varied among nurses at different levels. Conclusion: The hierarchical training model for nurses can improve the professional literacy and professional identity of nurses at all levels, optimize the quality of nursing services, and is a feasible and effective nursing human resource training strategy. It is recommended to further combine nurses’ career development paths to build a long-term and systematic hierarchical training system.

Impact of Advanced Emergency Nursing Education on the Care of Acute Myocardial Infarction Patients: A Case-Control Study

Hui Yang — 2026-03-12

Objective: To explore the impact of advanced emergency nursing education on the care of patients with acute myocardial infarction (AMI). Methods: A total of 66 AMI patients admitted to the hospital from June 2024 to June 2025 were selected and randomly divided into the control group and the observation group using a random number table, with 33 cases in each group. The control group received conventional health education, while the observation group received advanced emergency nursing education. The intervention duration was 3 months. The coronary heart disease self-management behavior scale was used to evaluate cognitive behavior; the 6-minute walk test and Activities of Daily Living (ADL) scale were used to assess rehabilitation effects; and health education satisfaction was evaluated. Results: After health education, the scores of disease cognition, symptom monitoring, bad habits, daily life, compliance, first-aid management, and emotional cognition in the coronary heart disease self-management behavior scale of the observation group were all higher than those of the control group (P<0.05); the 6-minute walk test distance and ADL score of the observation group were higher than those of the control group (P<0.05); the nursing satisfaction of the observation group was better than that of the control group (P<0.05). Conclusion: Advanced emergency nursing education can effectively improve the cognitive and behavioral abilities of AMI patients, promote rehabilitation effects, and achieve high satisfaction.

A Study on the Effectiveness of Cardiac Rehabilitation Nursing for Patients with Coronary Atherosclerotic Heart Disease Following Interventional Therapy

Hongyun Cai — 2026-03-12

Objective: To investigate the efficacy of cardiac rehabilitation nursing in patients with coronary atherosclerotic heart disease (CAD) following interventional therapy, providing evidence for optimizing clinical nursing protocols. Methods: Eighty CAD patients undergoing interventional therapy between January 2025 and June 2025 were enrolled. Using random number tables, they were divided into a study group and a control group (n=40 each). The control group received routine clinical care, while the study group received comprehensive cardiac rehabilitation care in addition to routine care. The following parameters were compared between groups: cardiac function indicators (LVEDD, LVESD, LVEF), 6-minute walk test distance, quality of life (SF-36 score), and incidence of adverse cardiovascular events. Results: After intervention, the study group demonstrated significantly lower LVEDD and LVESD and higher LVEF compared to the control group (P<0.05). The study group achieved longer 6-minute walk distances and higher SF-36 scores across all domains than the control group, with statistically significant differences (P<0.05). The incidence of adverse cardiovascular events was lower in the study group than in the control group, with statistically significant differences (P<0.05). Conclusion: Implementing cardiac rehabilitation nursing after interventional therapy in patients with coronary heart disease significantly improves cardiac function, enhances cardiopulmonary endurance and quality of life, and reduces the risk of adverse cardiovascular events, warranting clinical promotion and application.

The Impact of Early Family Nurturing Environments on the Intellectual and Behavioral Development of Preschool Children

Qian Zheng — 2026-03-12

Objective: To investigate the specific effects of early family nurturing environments on intellectual development and behavioral issues in preschool children aged 3–6 years, providing evidence-based support for early family intervention and child health care. Methods: This study investigated the early developmental processes of 300 children aged 3–6 years enrolled in the child health department of a community health service center from January 2024 to December 2025. The Family Nurturing Environment Questionnaire for Children Aged 3–6 was used to assess the family nurturing environment. The Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (WPPSI-IV) Chinese Version and the Achenbach Child Behavior Checklist (CBCL) were used to assess children’s full-scale IQ (FSIQ) and behavioral development levels. Results: A total of 300 valid questionnaires were collected. Among them, 163 children scored ≥85 on the family nurturing environment scale (high-quality nurturing environment group), while 137 children scored <85 (general environment group). Children in the high-quality environment group demonstrated significantly higher FSIQ totals than those in the average environment group, with all differences statistically significant (P < 0.05). Scores in the externalizing behavior domain, internalizing behavior domain, and competence domain were higher in the high-quality environment group, while scores in the dysregulation domain were lower, all differences statistically significant (all P < 0.05). Conclusion: The family nurturing environment significantly influences children’s early intellectual development and behavioral growth. It is recommended that relevant parents continuously enrich appropriate learning stimuli in home education, utilize positive and sensitive parent-child interactions, and adopt warm and accepting parenting styles to enhance children’s cognitive abilities and promote their positive behavioral development.

The Impact of PDCA Continuous Quality Improvement on Managing Elderly Patients with Dysphagia

Ting Zhou — 2026-03-12

Objective: To investigate the effect of PDCA continuous quality improvement on the management of elderly patients with dysphagia. Methods: Sixty elderly patients with dysphagia admitted to a hospital between June 2024 and May 2025 were selected and randomly divided into a control group (n=30) and an observation group (n=30) using the mean score method. The control group received routine clinical management. The observation group additionally implemented the Plan-Do-Check-Act (PDCA) continuous quality improvement management. The incidence of aspiration, improvement rate of swallowing function, and patient satisfaction were compared between groups. Results: After intervention, the aspiration incidence in the observation group was 6.67%, significantly lower than the control group’s 30.300% (P<0.05). The overall improvement rate in swallowing function in the observation group was 96.67%, significantly higher than the 73.33% in the control group (P<0.05); The overall satisfaction rate in the observation group was 100%, significantly higher than the 73.33% in the control group (P<0.05). Conclusion: Applying the PDCA cycle to the clinical management of elderly patients with dysphagia effectively reduces aspiration risk, promotes recovery of swallowing function, and significantly enhances patient and family satisfaction, demonstrating positive value for widespread implementation.

Evaluation of the Application Effect of Predictive Nursing of Risk Identification Theory in Neonates with PICC Tube Placement

Xiaoling Liu — 2026-03-12

Objective: To explore the effect of predictive nursing based on risk identification theory in neonates with PICC. Methods: From November 2024, our hospital began to collect the neonatal case data of PICC catheterization in pediatrics. By November 2025, a total of 84 cases were included, and they were randomly divided into two groups by the method of drawing single and double numbers. Among them, 42 cases were given routine catheterization nursing as the reference group; Another 42 cases were treated with predictive nursing based on risk identification theory as the experimental group. The bleeding, swelling degree, nursing quality score, and complications were compared between the two groups. Results: The ratio of 0-I grade bleeding and 0-I grade swelling in the experimental group was significantly higher than that in the reference group (P<0.05). The scores of nursing quality in the experimental group were significantly higher than those in the control group (P<0.05). The total incidence of complications in the experimental group was 4.76%, which was significantly lower than that in the reference group (16.67%) (P<0.05). Conclusion: Predictive nursing based on risk identification theory can obviously reduce bleeding and swelling at the puncture point and improve the nursing quality, which should be actively promoted.

Factors Affecting Exclusive Breastfeeding Practices Between Rural and Urban Areas in Anhui Province, China: A Comparative Study

Junya Wang — 2026-03-12

Aim: This study aimed to compare the factors influencing exclusive breastfeeding (EBF) practices between rural and urban areas in Anhui Province, China, with a focus on identifying biophysical, social, and cultural determinants. Background: The World Health Organization and UNICEF both recognize exclusive breastfeeding as the optimal method of infant nutrition. In China, breastfeeding practices vary significantly between urban and rural areas due to factors such as cultural beliefs, healthcare services, socioeconomic status, and employment. This study aims to fill the research gap in Anhui Province, a rapidly urbanizing region. Methods: A quantitative comparative research design was employed, with data collected from 200 lactating mothers (100 from urban and 100 from rural areas) aged 18 years and above. The study used self-administered questionnaires that assessed demographic characteristics, biophysical, social, and cultural factors influencing EBF practices. Poisson regression analysis was conducted to examine the association between urbanicity and breastfeeding practices, adjusting for key variables such as age, employment, and income. Results: The study indicated that mothers in both rural and urban Anhui Province engaged more in exclusive breastfeeding (EBF) when supported by biophysical and social factors. Cultural influences were notably greater for rural mothers. Biophysical and social factors showed no significant differences between the groups. Regression analysis identified maternal age (31–35 years) and female infant sex as significant predictors of EBF. Employment negatively affected social support in both environments, while education and income impacted cultural attitudes towards EBF differently. Conclusion: Regardless of location, mothers who exclusively breastfeed highly value biophysical, social, and cultural factors. In urban areas, factors such as age, employment, and higher income significantly influence breastfeeding, while in rural areas, infant gender, marital status, income, and employment status are more crucial. Furthermore, both urban and rural mothers consider biophysical and social factors, but cultural factors are more prominent in the breastfeeding practices of rural mothers than urban mothers.

Observation of the Preventive Effect of Failure Mode and Effects Analysis (FMEA) Combined with Traditional Chinese Medicine (TCM) Characteristic Nursing on Pressure Injuries in Patients with Kidney Disease

Lei Shen — 2026-03-12

Objective: To explore the practical effect of Failure Mode and Effects Analysis (FMEA) combined with traditional Chinese medicine (TCM) characteristic nursing in preventing pressure injuries in patients with kidney disease, providing a referenceable practical basis for clinical nursing work. Methods: From January 2023 to June 2024, 120 patients with kidney disease in the nephrology department of the hospital were selected and randomly divided into a control group and an intervention group, with 60 cases in each group. The control group received routine pressure ulcer prevention nursing, while the intervention group received additional FMEA management mode and TCM characteristic nursing. The incidence of pressure ulcers, injury staging, nutritional status, skin scores, and nursing satisfaction were compared between the two groups. Results: The incidence of pressure injuries in the control group was 20.00%, while that in the intervention group was only 5.00%. Moreover, the injuries in the intervention group were milder and occurred later on average, with statistically significant differences between the two groups (P<0.05). In terms of nursing satisfaction, the intervention group reached 96.67%, significantly higher than the 83.33% in the control group, with this difference also passing statistical testing (P<0.05). Conclusion: The combined application of FMEA and TCM characteristic nursing can effectively reduce the risk of pressure injuries in patients with kidney disease, improve their nutritional and skin status, and enhance nursing satisfaction, demonstrating high clinical promotion value.

A Review of Research on Core Competencies for Registered Nurses

Xiuying Guo — 2026-03-12

Against the background of continuous transformation in global healthcare systems and the increasing complexity of nursing practice, the core competencies of registered nurses have attracted growing attention in nursing education, professional regulation, and workforce management. Clearly defining and systematically structuring nurse competencies is essential for ensuring safe, effective, and high-quality nursing care. Over the past two decades, a range of international organizations and national regulatory bodies have developed competency frameworks to articulate expectations for registered nurses across diverse clinical and organizational contexts. This review adopts an international perspective to synthesize and compare representative competency frameworks for registered nurses developed by the International Council of Nurses (ICN), the American Association of Colleges of Nursing (AACN), and the Nursing and Midwifery Council (NMC) in the United Kingdom. Key competency domains, structural characteristics, and underlying conceptual orientations of these frameworks are analyzed to identify areas of convergence and divergence. In addition, research on core competencies of registered nurses in China is reviewed, with particular attention to conceptual development, construction of evaluation instruments, and empirical applications in clinical and educational settings. The findings indicate substantial consistency across international competency frameworks in core domains such as clinical care, patient safety, communication and collaboration, and professional values. However, notable differences remain in the emphasis placed on leadership development, informatics, and digital competencies, and pathways for competency progression across career stages. International frameworks increasingly conceptualize competence as a dynamic and context-dependent construct, moving beyond static lists of skills toward integrated and developmental models of professional capability. Within the Chinese context, existing studies have largely focused on competency measurement and cross-sectional assessments, while research examining the structural relationships and developmental trajectories of nurse competencies remains limited. Emerging methodological approaches, including competency mapping and computer-assisted text analysis tools, offer new opportunities to integrate multidimensional competency elements and enhance the transparency of framework development. This review highlights the value of international comparison for informing the refinement of registered nurse competency frameworks and underscores the need for further research that combines international evidence with local healthcare contexts. The findings may provide a reference for advancing competency-based nursing education, improving regulatory standards, and supporting the sustainable development of the nursing workforce in China.

Current Status and Influencing Factors of General Practitioners in Primary Medical Institutions: A Case Study of Xinyi City, China

Ying Zhuo — 2026-03-12

To investigate the current status of general practitioners (GPs) in primary medical institutions in Xinyi City, China, identify challenges, and propose evidence-based recommendations for workforce development. A mixed-methods approach combined a questionnaire survey of 100 residents, semi-structured interviews with 28 healthcare professionals, and analysis of secondary data from the Xinyi Health Commission. GPs in Xinyi face low educational attainment (76% with secondary education), an imbalanced urban-rural distribution (6.8 per 100,000 population), a “new-old transition” workforce (79% aged 27–42), inadequate compensation (60% of county hospital physicians’ income), and limited public awareness (only 25% familiar with GPs). Urgent comprehensive strategies are needed to strengthen GP training, improve incentives, enhance public awareness, and promote balanced distribution to build a stable, high-quality GP workforce for effective primary healthcare.

Application of a Cross-Theoretical Model-Based Frailty Management Program in Elderly Patients with COPD Comorbidities

Dan Liu — 2026-03-12

Objective: To investigate the effectiveness of a frailty management program based on a trans-theoretical model in elderly patients with chronic obstructive pulmonary disease (COPD) and comorbidities. Methods: From January to September 2025, 80 elderly COPD patients with comorbidities admitted to the Department of Respiratory and Critical Care Medicine were randomly assigned to an observation group (n=40) and a control group (n=40) using a random number table. The control group received routine nursing care, while the observation group underwent a frailty management program based on a cross-theoretical model. Pre- and post-operation compliance with frailty management, activities of daily living (ADL), pulmonary function indicators (FEV1, FEV1/FVC), and frailty (EFS) occurrence were compared between groups. Results: Post-intervention, the observation group demonstrated superior scores in frailty management adherence, ADL, and pulmonary function indicators compared to the control group (P<0.05), with a lower incidence of frailty (P<0.05). Conclusion: A frailty management program based on a cross-theoretical model effectively enhances frailty management adherence, improves pulmonary function and ADL, and reduces frailty incidence in elderly COPD patients with comorbidities, demonstrating clinical applicability.

A Scoping Review on the Application of Home Care Network Support Services for Patients with Urostomy and Their Caregivers

Ying Wang — 2026-03-12

Objective: This scoping review aims to summarize research on the application of network support for patients with urostomy due to bladder cancer and their caregivers, providing references for establishing a networked care system tailored to China’s national conditions. Methods: A systematic search was conducted across databases, including Web of Science, PubMed, the Cochrane Library, Embase, OVID, CNKI, Wanfang Database, and the China Biology Medicine Disc (CBM), using a combination of free-text terms and subject headings. The search covered the period from the inception of each database to August 6, 2025, with subsequent summary and analysis of the retrieved data. Results: A total of 13 studies were included. Network support platforms encompassed mobile applications, telemedicine platforms, online video conferencing tools, and cloud-based follow-up systems. The core functionalities included educational consultation and information sharing, psychosocial support, complication management, follow-up and interactive support, and electronic health record management. Evaluation metrics comprised quality of life, psychological well-being, self-management abilities, complication control, and care satisfaction. Conclusion: Network support models based on diverse platforms can effectively enhance the quality of home care and health outcomes for patients with urostomy and their caregivers, demonstrating feasibility and potential for widespread adoption. Future efforts should focus on optimizing personalized intervention designs, improving technological accessibility, and refining policy support systems to facilitate the establishment of an integrated hospital-home-community transitional care network.