2Peterson ED, Aibert NM, Amin A, et al. Implementing critical pathways and a multidisciplinary team approach to cardiovascular disease management [J]. 3an J Cardiol,2008,102(5A) :47G- 56G.
3McMistor FA, Stewart s, Ferma S, et al. Multidisciplinary strategies for the management of heart failure patients at high risk for admission: a sys- tematic review of randonfized trials [ J ]. J Am Call Cardiol, 2004,44 (4) : 810-819.
4DeWalt DA, Malone RM, Bryant ME, et al. A heart failure self-manage- ment program for patients of all literacy levels: a randomized, controncd trial[J]. BMC Health Serv Res,2006,30(6) :l - 10.
6Scott JR,Gibran NS,Engrav \A\,etal. Incidence and characteris-tics of hospitalized patients with pressure ulcers: State of Wash-ington, 1987 to 2000[J], Plast Reconstr Surg,2006,117(2) : 630 -634.
7Efstathiou N,Clifford C. The critical care nurse’s role in end - of -life care: Issues and challenges [J]. Nurs Crit Care,2011,16(3):116-123.
8Gagliardi AR, Dobrow MJ? Wright FC. How can we improvecancer care? A review of interprofessional collaboration modelsand their use in clinical management[J]. Surg Oncol, 2011? 20(3):146 - 154.
9Naylor MD. Advancing high value transitional care: The centralrole of nursing and its leadership[J]. Nurs Adm Q,2012,36(2):115-126.
10Watts RJ,Pierson J, Gardner H. How do critical care nurses de-fine the discharge planning process? [J]. Intensive Crit CareNurs,2005,21(1) :39 - 46.