Summary of Nursing Assistance to Xinjiang Experience: A Qualitative Study (2019–2025) of Local Nurses at Tiemenguan People's Hospital, Xinjiang

Summary of Nursing Assistance to Xinjiang Experience: A Qualitative Study (2019–2025) of Local Nurses at Tiemenguan People's Hospital, Xinjiang | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Summary of Nursing Assistance to Xinjiang Experience: A Qualitative Study (2019–2025) of Local Nurses at Tiemenguan People's Hospital, Xinjiang Wang Ruining, Chen Haiying, Hou Linmei, Zhang Xiuguo, Liu Yue, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8075197/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract Objective: To explore the perceptions and experiences of local nurses at Tiemenguan Hospital in Xinjiang regarding nursing assistance to the region, and to examine its impact on nursing work and hospital development. Methods: Semi-structured, in-depth interviews were conducted with eight local nurses who worked at Tiemenguan Hospital from September 2019 to September 2025. Purposeful sampling was used to capture authentic experiences, and the Colaizzi seven-step method was applied to analyze, extract, and synthesize the interview data. Results: After repeated reading and coding, four major themes and 13 sub-themes were identified: (1) The significance and value of nursing assistance to Xinjiang; (2) The implementation effects of nursing assistance to Xinjiang; (3) The obstacles faced by nursing assistance to Xinjiang; (4) Future expectations for nursing assistance to Xinjiang. Conclusion: Based on the experiences of local nurses in this study, nursing assistance to Xinjiang plays a crucial role in enhancing nursing standards at grassroots hospitals and supporting hospital development. However, its sustainability is limited by staff turnover and institutional challenges. It is recommended to deepen assistance through institutionalization, platform-building, and specialization, thereby achieving “assistance that goes beyond technology and sustains itself locally.” Nursing Assistance to Xinjiang Local nurses Qualitative research Introduction Since the founding of the People's Republic of China, the central government and provincial and municipal authorities have continuously provided support and assistance to Xinjiang. [1] Since the 18th National Congress of the Communist Party of China, the Party Central Committee has positioned Xinjiang as a strategic highland for “stabilising and developing the region and ensuring long‑term peace and prosperity [2] . A series of policy documents has emphasized a multi-dimensional approach—financial, industrial, talent-related, and others—to achieve leapfrog economic and social development in Xinjiang [3] . “Targeted assistance to Xinjiang” is a national‑level coordinated deployment that has formed a working pattern of “national overall planning, precise pairing, long‑term assistance, and coordinated governance.” The core objective of targeted assistance is to shift from a “blood‑transfusion” model to a “blood‑generation” model, thereby enhancing the self‑development capacity of the recipient regions [4] . Hebei Province is one of the provinces that actively participates in targeted assistance. In recent years, Hebei has signed a framework agreement with Bayin’gholin Mongol Autonomous Prefecture, promoting multi-level cooperation in project investment, talent exchange, and technology transfer. This has created a new model of “Hebei–Bayin’gholin” industrial docking, talent cultivation, and coordinated public‑service development. In September 2019, the Third Hospital of Hebei Medical University signed a management-entrustment agreement with the People's Hospital of Tiemenguan City, the 2nd Division of the Xinjiang Production and Construction Corps. This initiated a 12-year overall management model, during which the hospital's hardware facilities were upgraded, providing a solid organizational platform for nursing assistance in Xinjiang. Frontier regions face nursing personnel shortages and technical gaps, limiting local medical quality. Nursing assistance to Xinjiang's grassroots facilities, via a “mentor‑apprentice” model, transfers advanced concepts and management experience, accelerating recovery, reducing complications, and enhancing care. Since 2019, the Nursing Department of the Third Hospital of Hebei Medical University has consistently provided high-quality nursing techniques and management talent to Tiemenguan Hospital. Over the past six years, the hospital's nursing technical operation level and management capacity have progressed from a basic grassroots level to a tertiary-hospital standard, and it has begun to stand out in nursing competitions across Xinjiang and the Corps. Existing research shows that transforming "blood-transfusion" into "blood-generation" depends on talent cultivation and strong institutional management. Sustainable assistance requires long-term training of nursing talent and localized management systems. Targeted assistance has improved equal access to basic public health services and enhanced medical care in Xinjiang. However, the long-term results, nurses' experiences, and practical challenges of nursing assistance lack systematic qualitative analysis. This study examines the perceptions of local nurses at Tiemenguan Hospital regarding nursing assistance in Xinjiang. The primary research question is: What are the views and needs of these nurses, and what factors influence their perspectives? Based on national policies, targeted assistance layouts, Hebei's support experience in Bayingolin Mongol Autonomous Prefecture, and the management of the Third Hospital of Hebei Medical University, the research investigates nurses' knowledge, influencing factors, and improvement needs. The findings will provide evidence for refining assistance training, enhancing institutional effectiveness, and retaining talent. This will promote a shift from “blood‑transfusion” to “blood‑generation” and support sustainable nursing development in frontier regions. Methods General information A purposive sampling strategy was employed, selecting participants according to their work schedules, professional status, and the principle of maximum variation [5] . Local nurses who met the inclusion criteria and worked at Tiemenguan Hospital were invited to interviews. Inclusion criteria: (1) Working at Tiemenguan Hospital, (2) Possession of a valid nursing practice licence registered at Tiemenguan Hospital, (3) Continuous employment at Tiemenguan Hospital since September 2019. Exclusion criteria: (1) Nursing assistance personnel, (2) Nurses who joined after September 2019. The sample size was determined by data saturation, which involved continuing interviews until no new themes emerged. Eight nurses were interviewed and are anonymised as N1–N8. The study received ethics approval from the Tiemenguan Hospital Ethics Committee. Participant demographics appear in Table 1. Development of the Interview Guide The interview guide used in this study was specifically developed for the present research and has not been published elsewhere. It was constructed based on a systematic literature review and iterative discussions within the research team, which included qualitative-research nursing experts from the Third Hospital of Hebei Medical University, nursing management specialists, the Director of the Nursing Assistance Department at Tiemenguan Hospital, and five local head nurses. This multi-stakeholder collaboration ensured the guide’s comprehensiveness, cultural appropriateness, and alignment with the study’s research objectives. After drafting the initial version, two local nurses (who did not participate in the formal interviews) were invited to complete pilot interviews to test the guide’s clarity and feasibility. Feedback from the pilot phase was used to refine question wording, adjust the sequence of items, and eliminate ambiguous content. The final interview guide consisted of the following five items (e.g., “Please describe your understanding of nursing assistance to Xinjiang”). The interview guide is provided in Appendix 1. Data collection and quality‑control procedures Guided by a descriptive phenomenological framework, data were gathered through semi-structured interviews. All interviewers were members of the nursing department, held master's degrees, and had completed formal training in qualitative research methods. Their familiarity with the hospital's various departments and the established rapport with participants facilitated a trusting environment that encouraged cooperation. Before each interview, the research purpose and significance were explained to the participants, and written informed consent was obtained [6] . Interviews were conducted in the handover rooms of the respective wards, which provided a quiet and comfortable setting free from interruptions by unrelated personnel, ensuring the privacy of the interviewees. With full respect for each nurse's personal wishes [7] , an open-ended questioning style was employed to invite nurses to share their thoughts and prompt recollection of their six-year experience with nursing assistance in Xinjiang. Upon agreement, the entire interview was audio-recorded using a digital voice recorder, and contemporaneous field notes were taken to capture non-verbal cues, such as facial expressions and body language. Each interview lasted between 30 and 45 minutes. The combination of audio recordings and detailed field notes enhanced the credibility of the data and supported subsequent phenomenological analysis. Data analysis Within 24 hours after each interview, the field notes and audio recordings were organized. The recordings were transcribed verbatim into Microsoft Word documents; any omissions or transcription errors were promptly verified against the original audio files. A second member of the research team independently cross-checked the transcripts for accuracy [8] . The finalized transcripts were then imported into NVivo 12 for systematic coding. Two researchers independently applied Colaizzi’s 7 [9] phenomenological method to analyse the data and extract themes. (1) Familiarisation– read all transcripts repeatedly to obtain a holistic sense of the material. (2) Identifying significant statements–extract statements that directly pertain to the phenomenon under investigation. (3) Formulating meanings–interpret the extracted statements to uncover underlying meanings. (4) Clustering themes–group formulated meanings into theme clusters that reflect common concepts. (5) Developing an exhaustive description – integrate the theme clusters into a comprehensive description of the lived experience. (6) Producing the fundamental structure–distil the exhaustive description into a concise statement of the phenomenon's essence. (7) Member checking–return the description to the participants for validation. Following the analysis, the research team conducted a joint audio review session. Two researchers compared their preliminary thematic findings, discussed discrepancies, and reached consensus to ensure the credibility, accuracy, and completeness of the final dataset. Ethical considerations Ethical approval for this study was obtained from the Medical Ethics Committee at the research site. Before the interviews, all participants were informed of the study's aim, details, and the voluntary nature of their participation, either verbally or in writing, and then signed an electronic consent form via WeChat or email. Results The study ultimately included eight local nurses, who were assigned identifiers N1–N8 according to the sequence of their interviews. By applying Colaizzi's seven‑step phenomenological analysis to compare and integrate the coded data, and through collective discussion within the research team, the final results were derived. A total of four themes and thirteen sub‑themes were extracted (Table 2). Significance and Value of Nursing Assistance to Xinjiang This theme captures local nurses’ understanding of nursing assistance in Xinjiang by emphasizing the program’s core values: advancing healthcare through technology, promoting professional growth, and providing emotional support. This summary of years of practice highlights three ways frontline nurses contribute: introducing advanced technologies, cultivating professional development, and providing emotional support to the people of Hebei and Xinjiang. Introduction of Advanced Nursing Technologies The nursing‑assistance program of the Third Hospital of Hebei Medical University, through systematic technology introduction and department development, has markedly enhanced the medical service capacity of Tiemenguan Hospital and elevated the professional competence of its nursing staff, thereby laying a solid foundation for the sustainable development of nursing services in frontier regions. N1, N4: Before Director Dong arrived, no operations had been performed as a brigade-level hospital. After she established the operating room, Tiemenguan Hospital entered a new chapter. N2: Building on Director Dong's innovations, Wang Li brought the PICC technology to our hospital and taught us how to insert and care for the catheters. N8: In 2022, Director Zheng Jun‑ting’s nursing team initiated further assistance, establishing a hemodialysis unit and a central sterile services department (CSSD). We started building the hemodialysis unit in 2022 and began using it in 2023. Now, patients no longer have to travel 100 km to Kuerle Hospital for dialysis. N7: With these specialists, such as PICC and hemodialysis experts, we have gradually incorporated the corresponding nursing skills they introduced into our daily practice. Cultivation of Nurses’ Professional Growth The nursing-assistance project, by implementing systematic specialty training and diversified learning pathways, has significantly promoted the professional growth and occupational identity of nurses at Tiemenguan Hospital, thereby establishing a solid foundation for the long-term, sustainable development of the nursing workforce in frontier regions. N7 : After Director Zheng arrived, I was sent to Hebei to study hemodialysis specialty nursing, which I had never encountered before. N2: Following the footsteps of the nursing‑assistance experts, I learned critical‑care specialty nursing in Hebei and obtained a specialty‑nurse certificate. This has been immensely helpful for my future career planning. N3: The arrival of the Third Hospital’s nursing‑assistance experts gave many of our nurses the chance to pursue further study, whether at the Corps Hospital, the regional hospital, or in Hebei. These experiences broadened our horizons and elevated our nursing competence. Emotional Support for the People of Hebei and Xinjiang The nursing team dispatched from the Third Hospital of Hebei Medical University not only delivered technical expertise and services but also forged an emotional bridge that links the two regions, creating a warm, “family-like” atmosphere between Hebei and Xinjiang. The support manifested through listening, encouragement, sharing, resonance, ritual, and mutual assistance. N5: The nursing mentors sent to Xinjiang listen attentively. They take time to sit with us, discuss issues specific to Tiemenguan, and address our questions and concerns. N8: We had never participated in skill competitions before. The assistance nurses motivated us to strive for excellence. Even without winning, we felt rewarded and fulfilled. N4: Every Nurse's Day is celebrated spectacularly, and on each nurse’s birthday, the hospital remembers us and sends a birthday card. It adds a strong sense of ceremony. We truly feel like one big family. Although Hebei and Xinjiang are far apart, the assistance program makes the distance feel much shorter. Whenever we encounter any issues, the nursing staff is always ready to assist us. Implementation Outcomes of Nursing Assistance to Xinjiang The distinct nature of the nursing‑assistance work has prompted local nurses to discuss its outcomes from multiple perspectives, which can be grouped into three categories: dissemination of nursing techniques, improvement of systems and quality, and enhancement of patient satisfaction. Dissemination of Nursing Techniques Under the guidance of the nursing assistance team, nursing techniques at Tiemenguan Hospital have been systematically disseminated across disciplines, and all interviewed nurses reported the sub-theme of nursing technology dissemination. N8: With the increasing number of new surgeries, we have also begun to engage in related nursing procedures and skills, such as operating mechanical ventilators (machines that assist or replace spontaneous breathing), invasive arterial pressure monitoring (measuring blood pressure directly from an artery), and continuous renal replacement therapy, or CRRT (a procedure to support kidney function over an extended period). N3: The central sterile services department was established with the assistance of nursing experts; now that it has been handed over to us, it runs smoothly. This represents a major contribution of the assistance program。 N4: During quality‑control activities, I was unfamiliar with the PDCA cycle. After guidance from the nursing assistant mentors, I learned that it is a quality management tool, and I feel that my professional competence has been enhanced. Institutional and Quality Improvements Guided by the nursing-assistance team, systematic reforms—including the streamlining of institutional procedures, standardization of documentation, unification of teaching tools, and the implementation of patient-safety-oriented quality management—have significantly enhanced the hospital’s regulatory compliance and nursing quality standards. These changes have not only rendered workflows more efficient and traceable but also fostered a culture of continuous improvement driven by quality indicators across the entire institution, thereby laying a solid foundation for the long‑term development of healthcare services in frontier regions. N4: Previously, the hospital lacked formal written documents. After Director Zheng arrived, a complete set of nursing policies was established and subsequently adapted to the actual conditions of our hospital。 Now every department's ledger is complete, from the first folder to the last; the contents and printing format of each folder are standardized across the hospital. N2: Currently, under the leadership of the assistant nurses, our department is required to submit data to both the national nursing quality data platform and the Corps' nursing quality database. We must meet all 25 nationally mandated sensitive indicators, which forces us to use these indicators as benchmarks and consequently raises the overall quality of nursing. Previously, the workflow extended from start to finish, with responses occurring only when patients complained. The situation has changed: assessments are now conducted first, nursing care is provided subsequently, and patient safety is placed at the core of practice. Improvement in Patient Satisfaction The nursing-assistance team's use of dynamic evaluation, innovative health education, continuity of care, and home-visit nursing has improved patients' perceived quality of care and satisfaction. Nurses now proactively communicate, teach interactively, and provide comprehensive care. As a result, patient recognition and gratitude have increased, reinforcing the value of nursing. Nurse N8 explained, "Previously, we would not check on patients unless they called us. Now we are required to patrol patients according to nursing grades, conduct an initial assessment on admission, and perform dynamic re-assessments, which forces us to communicate with patients more frequently." N2: I used to deliver health education by simply reading from a script. With the new health‑education approach, patients now understand the information much more comprehensively. N7: Previously, we only presented banners to doctors. In our department, we now also give nurses banners, and one even bears my name! N6: From admission to discharge, we follow a continuous care pathway. When a patient returns for a follow-up, we already know their previous diagnosis, and we greet them before they have a chance to speak. N4: One patient informed us that your hospital offers home-visit nursing services—this is the first time I have encountered such a service in Xinjiang. Challenges Faced by the Nursing Assistant in Xinjiang The nursing-assistance program has raised nursing standards at Tiemenguan Hospital. However, local nurses reported three main challenges: increased workload and pressure, difficulties in adapting new practices to the local context, and frequent staff turnover, which caused incomplete handovers and a lack of follow-up. Increased Workload and Stress During the nursing‑assistance process, nurses experienced heightened work pressure as a direct consequence of deeper systemic factors inherent to the programme. The hospital is striving to achieve a secondary‑grade status, which requires the collection of numerous indicators. Because we lacked an information management system, it was difficult to handle, and the pressure felt during that period was immense. To improve patient-safety indicators, the hospital set higher pass-rate targets for nursing-quality metrics, such as pressure injuries, falls, and thrombosis. Significant efforts were made to meet these rates, and at times, it was exhausting. N4: The number of newly established departments is increasing, and the case mix is becoming more complex. Occasionally, we are short-staffed, so we have to support multiple wards, ensure coverage, and also take on teaching responsibilities. It feels as if I have been split into several people, while still having children at home。 N4: Although the workload has increased dramatically, it is mainly because we were previously too relaxed, so the fatigue is more noticeable now。 N1: This is also a necessary path for improving professional competence and advancing local nursing standards. If we don’t learn now, when will we? Difficulty of Local Adaptation The nursing-assistance project faces significant challenges in localizing its technologies and management systems, aligning national quality indicators with the hospital's actual workload, building research capacity, and matching specialist nurse positions. These issues constrain the effective translation and sustained advancement of advanced nursing practices at Tiemenguan Hospital. N1: The nursing department requires that hemodialysis data be collected and reported to the Corps and the national health authorities. The Third Hospital has an information system in place to automate this process, but the hemodialysis unit at Tiemenguan Hospital is a newly established unit and lacks such a system. We must rely on manual statistics, which are cumbersome and prone to errors, yet the reports cannot be omitted。 N3：Under the direction of the nursing department, our hospital joined the national nursing data quality platform in 2024 and is now required to submit sensitive nursing indicators. The Third Hospital is a tertiary-grade institution, whereas we are a secondary-grade hospital with a much smaller patient volume. For indicators such as the incidence of tracheal extubation, we have virtually no cases, resulting in many data points being zero, which can be perceived as meaningless. Similarly, for central‑venous catheter infection rates, the hospital lacks the capacity for bacterial cultures, so those figures are also zero。 N7: We are encouraged to conduct research, publish articles, and write reviews. I understand this is meant to develop research thinking. However, I have no experience with manuscripts or CNKI. Promotion here does not require publications, but learning research skills could still support growth and broaden perspectives. Despite this, I am still hesitant to invest effort. Frequent Turnover of Assistance Staff, Incomplete Handover, and Lack of Follow-up The high turnover of nursing-assistance personnel creates compressed handover periods and incomplete information transfer, which in turn lead to a series of problems: specialization bias, frequent changes in management approaches, and a lack of post-implementation follow-up. These interrelated factors undermine the continuity and sustainability of the assistance program, thereby compromising the long-term impact on nursing quality improvement at Tiemenguan Hospital. Since 2019, each newly appointed cohort of nursing assistant teachers has had only a few days for handover, which restricts thorough explanation of hospital practices and hinders transition efficiency. N1: Each assistance nurse has a different specialty. Some teachers have a broad skill set and can, over the course of a year, improve the overall nursing management at Tiemenguan Hospital. Others are highly specialized and are less adept in other areas, resulting in a bias toward their own field during their tenure。 When a teacher prefers one management style and the incoming teacher prefers another, the management approach shifts completely after handover. This abrupt change presents difficulties for the team in adapting. Without a comprehensive handover, new assistant nurses spend valuable assignment time familiarizing themselves with the hospital, limiting their ability to implement changes quickly within the one-year period. N3: The hospital lacks a continuous tracking platform. After an assistant nurse departs, no one monitors whether the professional or managerial level she was responsible for has improved or declined。 Expectations and Recommendations for Nursing Assistance to Xinjiang As the direct beneficiaries of the nursing‑assistance program, local nurses possess firsthand recommendations and unique perspectives on nursing assistance. Interviewing them to gather suggestions for improving the program is of great value for more effective implementation of nursing assistance and for enhancing the nursing standards of frontier hospitals. Looking Forward to Continued Dispatch of Nursing Assistance Personnel Interviewees believe that nursing assistance should be coordinated with medical assistance, maintaining long‑term, complementary personnel dispatches to ensure the continuity and overall effectiveness of the assistance program. Building on this perspective, N1 explains that medical assistance alone is insufficient; without parallel nursing support, the entire system will break down. Echoing this sentiment, N2 states that they hope nursing instructors will continue to be dispatched for assistance; otherwise, previous efforts may be felt as wasted. N4 emphasizes that nursing should develop in tandem with medical services; when specialist medical experts are dispatched, corresponding nursing specialists should also be sent to ensure joint advancement. Recommendation for the Third Hospital of Hebei Medical University to Dispatch Nursing‑Assistance Personnel According to the Departmental Structure of Tiemenguan Hospital Interviewees expressed that the Third Hospital of Hebei Medical University should align its nursing‑assistance dispatches with the departmental structure of Tiemenguan Hospital, targeting the deployment of specialist nursing personnel to achieve rapid capacity building and sustainable development of each department. N1: The hemodialysis unit, under the guidance of the nursing assistant staff, has been developed into a high‑quality department that resembles a tertiary‑grade ward; this outcome is highly satisfactory. N2: I hope that when the Third Hospital sends staff again, a dedicated nurse for the interventional suite can be dispatched. With a one-year effort to establish the interventional suite, the hospital’s overall condition will gradually improve, just as the hemodialysis and sterilization units were previously built. N6: The hemodialysis and sterilization units serve as typical examples; if a specialist nurse for orthopaedics is sent next year, the nursing and management standards of the orthopaedic department will be elevated accordingly. Improving the Handover of Nursing‑Assistance Personnel to Prevent Restarting By standardizing handover documentation, detailing the content of handovers, ensuring continuity of professional development, and appropriately managing interpersonal relationships, the quality of nursing-assistance handovers can be significantly improved, preventing redundant restarts and ensuring that assistance work proceeds continuously and smoothly. N5: Standardize all materials and documents provided annually by the nursing-assistance instructor to match those of the Third Hospital. This will prevent incoming instructors from having to face the cumbersome task of revising all materials. During handover, the nursing‑assistance instructor must deliver a detailed shift report. This report should identify each nurse’s development stage, each department’s shortcomings, and any adverse departmental culture. It must also note which nurses have been specifically cultivated for managerial capacity and could be groomed as future head nurses. All of this information needs to be transferred. N7: Address training inequities by ensuring that specialist nurse training records are transferred during handover. This prevents new instructors from assigning duplicate or unnecessary specialty training. Recommendation to Establish a Nursing‑Assistance Tracking Platform to Institutionalize Communication and Follow‑Up Across Cohorts of Nursing‑Assistance Personnel To realize these benefits, actively implement an information technology platform, maintain stable management, and foster ongoing technical exchanges to address poor handovers, repetitive work, and loss of experience. Take these actions to support nursing care in frontier regions, enhance teamwork among medical and nursing staff, and drive meaningful improvements in healthcare quality in Xinjiang. Establish an online platform and begin holding regular meetings with previous nursing-assistance instructors to review past work and plan ahead. Take the initiative to organize these meetings and solicit input from all participants. N3: After the assistance instructors leave, there should be a timely follow‑up to see whether the work they carried out has been sustained. If it has not been implemented, who should be contacted for further information? Who should be consulted? This is lacking because the instructor’s expertise is best understood by herself. N4: When the assistance instructors depart, can we continue to communicate with the Third Hospital? If we want to keep attending courses offered by the Third Hospital, whom should we approach? This needs to be arranged before they leave, with a clear plan in place. N5: From the hospital’s perspective, a formal system should be established to standardize the duties of nursing‑assistance instructors, especially concerning handover procedures and subsequent follow‑up. Discussion This qualitative study involved eight local nurses who had each participated in a six-year nursing assistance program. The majority of participants considered nursing assistance to be an effective strategy for enhancing the quality of nursing care in their hospitals. The nurses recounted their personal experiences and identified the activities they considered most valuable within the nursing-assistance framework [ 10 ] . Findings indicate that nursing assistance has a positive influence on the professional development of local nurses, enhances technical competencies, and fosters stronger inter-provincial relationships. Nevertheless, several implementation challenges emerged during the programme. Based on the interview data, the participants offered a series of recommendations aimed at optimizing nursing-assistance policies to further strengthen the sustainability and impact of the initiative [ 11 ] . Exploring the Value of Nursing Assistance in Xinjiang for Technological Advancement, Professional Development of Nurses, and Emotional Bonding at Tiemenguan Hospital The implementation of nursing assistance at Tiemenguan Hospital has provided local nurses with the most immediate benefit: the introduction of advanced nursing technologies, particularly over the past six years. This study demonstrates that the establishment of an operating theatre provided a hardware platform for subsequent high-risk surgeries, while the creation of a central sterile services department ensured logistical support for surgical safety. The introduction of mechanical ventilation and endotracheal intubation techniques further expanded the scope of critical-care nursing, forming a positive “technology-chain” cycle. The launch of a hemodialysis unit directly alleviated the burden of patients traveling 100 km across regions, markedly improving patients' well-being and quality of life [ 12 ] . Although the technological introductions achieved notable outcomes, constraints in equipment configuration and staff experience necessitate further localization through on‑the‑job training and standardized operating procedures. Multiple interviewees repeatedly emphasized this adaptation process, suggesting that future research should explore the key success factors of technology transfer [ 13 ] . Quantitative data indicate that from 2019 to 2025, nursing‑assistance personnel trained 25 specialist nurses, demonstrating a “seed” effect of the program on the development of a professional talent pipeline [ 14 ] . Interviewees highlighted a range of specialties—including critical care, emergency, operating theatre, hemodialysis, PICC line placement, wound ostomy care, geriatric nursing, traditional Chinese medicine, and central sterile services—that have markedly deepened the professional expertise of the nursing team at Tiemenguan Hospital. Through external training programs and the acquisition of specialist nurse certifications, nurses have established clear career development pathways, thereby strengthening their professional identity. The establishment of eight dedicated specialty groups has provided nurses with specialized work platforms, facilitating systematic knowledge management and the transmission of expertise. This organizational structure contributes to the formation of a “learning organization,” which, in turn, enhances overall nursing quality and effectiveness. Opportunities for professional growth are typically positively correlated with nurses' intentions to remain in their profession. Over the past five years, only five nurses have left Tiemenguan Hospital, while the total nursing staff has increased from 23 in 2019 to 96 in 2025. High-quality nursing talent from multiple corps-affiliated and local hospitals has flowed into Tiemenguan Hospital, indicating the institution’s strong appeal for nurses’ career prospects. These favorable evaluations from local nurses demonstrate that nursing assistance has played an active role in attracting talent and reducing turnover at Tiemenguan People's Hospital. Going forward, the hospital should continue to align talent recruitment and retention strategies with its disciplinary development, actively introducing new technologies to sustain and further enhance its nursing capacity. In addition to the technical and career-building aspects, interviewees repeatedly emphasized the importance of emotional interactions—such as listening, encouragement, sharing, and ritualized activities—which are especially critical in cross-regional assistance. Symbolic events such as International Nurses Day celebrations and birthday cards create a sense of “family-like” warmth for the assisted nurses, thereby strengthening team belonging. This emotional support is regarded as “emotional capital [ 15 ] ”, helping to sustain motivation in resource-constrained settings. Nursing-assistance experts provide narrative-care opportunities that allow nurses to express work-related stress and emotional experiences, enhancing psychological safety and indirectly improving nursing quality [ 16 ] . Through attentive listening to local needs and sharing nursing practices from Hebei, the assistance experts foster bidirectional learning and cultural complementarity, establishing a “Hebei-Xinjiang family” social network. Such a network facilitates rapid information flow, resource sharing, and offers a replicable emotional model for future assistance initiatives in other regions [ 17 ] . Comprehensive Effects of Nursing Assistance in Xinjiang on Technological Dissemination, Institutional Quality Improvement, and Patient Satisfaction at Tiemenguan Hospital Interviewees consistently reported that nursing-assistance experts helped the hospital create a complete nursing management system, standardize documentation templates, develop a quality-data reporting framework, and design patient-safety-oriented workflows. The transition was significant: the hospital moved from "no formal written materials" to a "hospital-wide unified filing system." This change highlights a key outcome: building institutional structures standardizes organizational behavior [ 18 ] . Furthermore, uniform procedures increase work efficiency and supply foundational data for later quality monitoring. In turn, reporting to the national nursing quality data platform and the Corps’ nursing quality database requires the hospital to meet 25 sensitive indicators. This external driver subsequently raises internal standards[ [ 19 ] . Additionally, standardizing PPT templates and case-discussion formats regularizes teaching and research. As a result, the quality of knowledge dissemination improves. Patients moved from "no complaints, no inquiries" to "active communication, dynamic assessment, and home-visit services." This shift reflected a qualitative leap in satisfaction [ 20 ] . Similarly, care changed from "executing medical orders" to "nursing-level rounds, health education, and continuous follow-up," showing an evolution in nursing service philosophy. Furthermore, nurse-presented banners and home-visit services reinforced emotional care and added a "finishing touch" to patient satisfaction. Nurses memorized the inpatient-to-outpatient-to-follow-up pathway and proactively contacted patients, creating a "closed-loop" nursing model that markedly increased patients' trust in the hospital. In resource-constrained frontier regions, emotionally oriented, continuous nursing interventions can compensate for limited hardware facilities [ 21 ] . It is therefore recommended that such practices be institutionalized and incorporated into nursing quality evaluation systems. Purely technical transfer or reliance on institutional construction alone is insufficient to achieve sustainable nursing improvement in remote, under-resourced settings [ 21 ] . Rapid technology dissemination requires the safeguarding of standardized procedures, while emotional connection is essential for maintaining team cohesion and enhancing patient satisfaction. The three elements—technology, institutionalization, and emotional linkage—mutually reinforce one another, forming a triadic support model that ensures the enduring impact of nursing assistance in the local context. Workload, Local Adaptation, and Handover Tracking: Three Major Challenges of Nursing Assistance in Xinjiang and Their Mitigation Strategies Interviewees N1 and N2 reported that to obtain secondary-grade hospital accreditation and meet patient-safety indicators (pressure injuries, falls, thrombosis, etc.), hospitals must collect substantial data. Without an information technology system, staff collect and analyze all data manually, which increases their workload. The hemodialysis unit also lacks an information system and must manually compile specialty indicators, increasing the risk of errors and adding to the workload. N3 further pointed out that the sensitive indicators required by the national nursing quality platform are difficult to report for a Level II hospital, where the patient base is small and cases are scarce. Because of this small patient base and limited cases, many “zero-value” entries are generated, thereby weakening the data's significance. Specialist nurses find it hard to play a role locally, as their limited research-writing skills prevent them from completing the required papers or reviews. This skill gap leads to low research motivation among nurses. Efforts to improve quality inevitably increase work pressure. Indicator-driven improvement is essential for nursing quality; however, without a supporting digital platform, nurses are pulled away from clinical care for heavy documentation, which may compromise clinical safety [ 22 ] . To address these issues, take these measures. First, deploy lightweight data-collection tools in key departments, then expand hospital-wide [ 23 ] . Second, within the national platform, develop “localized indicator thresholds” for Level II hospitals—for example, use “case rate per bed” rather than absolute numbers—to avoid statistical distortion from zero values [ 24 ] . Third, establish a “research starter group” that understands local nurses’ needs; invite research mentors from the Third Hospital of Hebei Medical University to provide online or offline guidance, including templates, literature search training, and CNKI workshops [ 23 ] . Finally, assign certified specialist nurses as “specialty consultants” to provide technical guidance and training rather than routine bedside care, leveraging their expertise. Interviewees identified three main handover issues: insufficient time, mismatched specialties, and the lack of a tracking platform. To address these: (1) Begin handover preparation one month before annual turnover, including a two-week "hand-over internship" for outgoing and incoming nurses to ensure thorough knowledge transfer [ 25 ] . (2) Implement a rotation schedule, enabling each group of assistance nurses to work in all critical departments and prevent specialty bias. (3) Establish a project progress tracking process where local nursing supervisors and assistant project leaders assess handover implementation and produce improvement reports. Nursing assistance is a systematic endeavor; the three major challenges—workload, local adaptation, and handover tracking—are interwoven. Addressing only one of them rarely leads to fundamental improvement in the assistance outcomes. The above recommendations can be compiled into a “Nursing Assistance Project Management Manual,” which can be disseminated to other remote‑area assistance projects nationwide to achieve standardized replication of experience. Nevertheless, an important issue remains: the assisting hospitals face constraints in personnel, finances, and material resources [ 26 ] . Analysis of Policy‑Level Recommendations for Implementing Nursing Assistance in Xinjiang The Corps Nursing Society and assisting provinces’ societies should create a unified “Nursing Assistance Data Platform” for Xinjiang [ 27 ] , This platform would coordinate nursing assistance across hospitals and regions, increasing efficiency, transparency, and resource sharing. Its main functions include: (1) Submitting and coordinating nursing-specialty needs; (2) Assessing and evaluating nursing-assistance projects; (3) Reporting and tracking work hand-overs for nursing assistance. To further enhance coordination, refine the bilateral assistance agreement to add hardware, software, IT, research, personnel handover, and workload provisions. This will establish an integrated management framework[ [ 28 ] . To strengthen local adaptation, a “Local-Adaptation Working Group” should be created [ 29 ] , This group should comprise experts from the partner hospitals and local medical staff. Each technology, indicator, and system would be customized locally before rollout. Two additional recommendations for future initiatives are as follows: (1) Expand the involvement of nursing-assistance experts beyond recipient hospitals to include a tertiary hospital within the same jurisdiction, thereby leveraging the strengths of nursing assistance and enabling high-quality nursing resources from Hebei Province to advance both the local tertiary hospital and the recipient hospital [ 30 ] . (2) Prioritize assistance to the local tertiary hospital in Xinjiang to reduce disparities between Xinjiang and other regions. Once the local tertiary hospital is strengthened, it can serve as a hub for an intra-regional assistance model, supporting secondary hospitals within Xinjiang [ 31 ] . Strengths and Limitations A key strength of this study lies in the fact that all participants are local nurses who have been involved in the nursing assistance program since its inception six years ago. This long-term engagement enables them to provide highly authentic and direct feedback on their experiences. As one of the first qualitative studies focusing on nursing assistance initiatives in Xinjiang, China, this research addresses a gap in the systematic exploration of this specific field. TwoThese favorable evaluations demonstrate that nursing assistance has played an active role in attracting talent and reducing turnover. Going forward, the hospital should continue to align talent recruitment and retention strategies with its disciplinary development limitations of the study should be acknowledged. First, the representativeness of the sample is constrained. All interviewees were recruited from a single recipient hospital, which operates under the entrustment of the Third Hospital of Hebei Medical University and has developed a distinct assistance model through long-term collaborative efforts. Consequently, the conclusions drawn may not be generalizable to hospitals that are independently managed or receive assistance from other provinces. Second, there are constraints related to geographical scope and applicability. Xinjiang is a geographically extensive region, and substantial variations exist in medical resource allocation and assistance models across hospitals in different areas. Therefore, the recommendations proposed in this study may not be fully applicable to remote regions or hospitals at different stages of development. Despite these limitations, this study still offers valuable insights into nursing assistance practices in Xinjiang, which can inform the optimization of future assistance programs. Conclusion This qualitative study offers new insights for provinces participating in nationwide nursing assistance programs, highlighting both the experiences gained and the challenges encountered during implementation. The findings underscore that nursing assistance not only introduces novel clinical techniques to nurses but also fosters their professional development and strengthens the bonds between the people of Hebei and Xinjiang. As a pioneering effort to investigate nursing assistance in China, the study emphasizes the initiative’s pivotal role within the broader strategy of balanced development between the eastern and western regions, illustrating the importance and exploratory nature of health-care assistance in Xinjiang. Nursing assistance has evolved into a tri-dimensional model integrating three key elements: technology, talent, and emotional connection. These, supported by institutional mechanisms, reinforce one another across four interrelated areas. This integrated approach has improved nursing quality in frontier hospitals. To achieve sustainable and standardized outcomes, the three core challenges—workload, local adaptation, and handover tracking—must be addressed concurrently, and policy measures should focus on:(1) Building a unified data platform for nursing assistance. (2) Refining bilateral assistance agreements. (3) Expanding the scope of assistance. Future research should use mixed-methods designs. It should conduct longitudinal comparative analyses across different assisting hospitals and recipient regions. Researchers should also test whether the current findings are generalizable and sustainable in the long term. Such work will provide an evidence-based foundation for scaling nursing assistance in China. Declarations Acknowledgements We thank all departments and all participants for this study. Funding No funding. Data availability The datasets generated and/or analysed during the current study are not publicly available due to the participant confidentiality, but are available from the corresponding author on reasonable re-quest. Consent for publication Not applicable. Competing interests The authors declare no competing interests. Author details 1 The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050000, China 2 Hebei Medical University, Shijiazhuang, Hebei, China 3 Tiemenguan Hospital (Affiliated with The Third Hospital of Hebei Medical University), Tiemenguan, Xinjiang, 841007, China Ethics approval and consent to participate The study was conducted in accordance with the Declaration of Helsinki (2024 revision) and the International Ethical Guidelines for Health-related Research Involving Humans. This study was approved by the Ethics Committee of Hebei Medical University Third Hospital Tiemenguan City People's Hospital. Written informed consent was obtained from all participants. References Kanbur R, Wang Y, Zhang XJCDP: The Great Chinese Inequality Turnaround . 2017 Xu G, Zhang J, Xie M, Du H, Guo M: Beijing's paired assistance program: Mitigating vulnerability, fostering development, and promoting equality in its ecological conservation areas . PloS one 2025, 20 (5):e0324817 Lu Z, Deng XJMP: China's Western Development Strategy: Policies, Effects and Prospects . MPRA Paper 2011 Wang Q, Tian Z, Zhu SJPO: Paired assistance and poverty alleviation: Experience and evidence from China . 2024, 19 (3) Gao K, Zhang S, Liu J, Zhang F, Liu N, Dong J, Zhang T, Gao J, Qin S, An JJSR: Supportive care needs of the family caregivers of urostomy patients: a qualitative study . Scientific Reports 2025, 15 (1) Vaismoradi M, Turunen H, Bondas T: Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study . 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J adv nurs 2022, 78 (9):2949-2959 Hughes EJNS: Nurses' perceptions of continuing professional development . Nursing Standard 2005, 19 (43):41 Leach R, Banerjee S, Beer G, Tencheva S, Conn D, Waterman A, Parrott J, Gifford J, Steddon S, Abbs I et al : QUALITY IMPROVEMENT: Supporting a hospital in difficulty: -experience of a '-buddying' agreement to implement a new medical pathway . Future healthcare journal 2019, 6 (1):67-75 Ray KN, Felmet KA, Hamilton MF, Kuza CC, Saladino RA, Schultz BR, Watson RS, Kahn JM: Clinician Attitudes Toward Adoption of Pediatric Emergency Telemedicine in Rural Hospitals . Pediatric Emergency Care 2017, 33 (4):250-257.https://dx.doi.org/10.1097/pec.0000000000000583 Chang KKP, Chan EA, Chung BPM: A new pedagogical approach to enhance palliative care and communication learning: A mixed-method study . Nurse education today 2022, 119 (-):105568 Zhang Y, Qiu R, Wang Y, Ye Z: Navigating the future: unveiling new facets of nurse work engagement . 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Cities 2024, 152 (000):17 Tables Table 1 Demographic characteristics of interview participants ( n = 8) ID SEX AGE Years at Hospital Professional Education Specialist‑Nurse Status N1 Female 36 2019.3 Senior Nurse associate degree Y N2 Female 33 2011.8 Senior Nurse Bachelor’s degree Y N3 Male 30 2019.5 Senior Nurse Bachelor’s degree N N4 Female 34 2011.7 Senior Nurse Bachelor’s degree Y N5 Female 38 2019.4 Senior Nurse Bachelor’s degree N N6 Female 26 2019.1 Nurse Bachelor’s degree Y N7 Female 27 2019.7 Nurse Bachelor’s degree Y N8 Female 28 2019.8 Nurse Bachelor’s degree Y Table 2 Real Experiences of Local Nurses at Tiemenguan Hospital with Nursing Assistance in Xinjiang Themes Subthemes Significance and Value of Nursing Assistance to Xinjiang Introduction of Advanced Nursing Technologies Cultivation of Nurses’Professional Growth Emotional Support for the People of Hebei and Xinjiang Implementation Outcomes of Nursing Assistance to Xinjiang Dissemination of Nursing Techniques Cultivation of Nurses’Professional Growth Improvement in Patient Satisfaction Challenges Faced by the Nursing Assistance to Xinjiang Increased Workload and Stress Difficulty of Local Adaptation Frequent Turnover of Assistance Staff, Incomplete Handover, and Lack of Follow‑up Expectations and Recommendations for Nursing Assistance to Xinjiang Looking Forward to Continued Dispatch of Nursing Assistance Personnel Recommendation for the Third Hospital of Hebei Medical University to Dispatch Nursing‑Assistance Personnel According to the Departmental Structure of Tiemenguan Hospital Improving the Handover of Nursing‑Assistance Personnel to Prevent Restarting Recommendation to Establish a Nursing‑Assistance Tracking Platform to Institutionalize Communication and Follow‑Up Across Cohorts of Nursing‑Assistance Personnel Additional Declarations No competing interests reported. Supplementary Files Appendix1.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviewers invited by journal 18 Dec, 2025 Editor assigned by journal 17 Dec, 2025 Editor invited by journal 18 Nov, 2025 Submission checks completed at journal 17 Nov, 2025 First submitted to journal 17 Nov, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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[1] Since the 18th National Congress of the Communist Party of China, the Party Central Committee has positioned Xinjiang as a strategic highland for “stabilising and developing the region and ensuring long‑term peace and prosperity\u003csup\u003e[2]\u003c/sup\u003e. A series of policy documents has emphasized a multi-dimensional approach—financial, industrial, talent-related, and others—to achieve leapfrog economic and social development in Xinjiang\u003csup\u003e[3]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e“Targeted assistance to Xinjiang” is a national‑level coordinated deployment that has formed a working pattern of “national overall planning, precise pairing, long‑term assistance, and coordinated governance.” The core objective of targeted assistance is to shift from a “blood‑transfusion” model to a “blood‑generation” model, thereby enhancing the self‑development capacity of the recipient regions\u003csup\u003e[4]\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eHebei Province is one of the provinces that actively participates in targeted assistance. In recent years, Hebei has signed a framework agreement with Bayin’gholin Mongol Autonomous Prefecture, promoting multi-level cooperation in project investment, talent exchange, and technology transfer. This has created a new model of “Hebei–Bayin’gholin” industrial docking, talent cultivation, and coordinated public‑service development.\u003c/p\u003e\n\u003cp\u003eIn September 2019, the Third Hospital of Hebei Medical University signed a management-entrustment agreement with the People's Hospital of Tiemenguan City, the 2nd Division of the Xinjiang Production and Construction Corps. This initiated a 12-year overall management model, during which the hospital's hardware facilities were upgraded, providing a solid organizational platform for nursing assistance in Xinjiang.\u003c/p\u003e\n\u003cp\u003eFrontier regions face nursing personnel shortages and technical gaps, limiting local medical quality. Nursing assistance to Xinjiang's grassroots facilities, via a “mentor‑apprentice” model, transfers advanced concepts and management experience, accelerating recovery, reducing complications, and enhancing care.\u003c/p\u003e\n\u003cp\u003eSince 2019, the Nursing Department of the Third Hospital of Hebei Medical University has consistently provided high-quality nursing techniques and management talent to Tiemenguan Hospital. Over the past six years, the hospital's nursing technical operation level and management capacity have progressed from a basic grassroots level to a tertiary-hospital standard, and it has begun to stand out in nursing competitions across Xinjiang and the Corps.\u003c/p\u003e\n\u003cp\u003eExisting research shows that transforming \"blood-transfusion\" into \"blood-generation\" depends on talent cultivation and strong institutional management. Sustainable assistance requires long-term training of nursing talent and localized management systems. Targeted assistance has improved equal access to basic public health services and enhanced medical care in Xinjiang. However, the long-term results, nurses' experiences, and practical challenges of nursing assistance lack systematic qualitative analysis.\u003c/p\u003e\n\u003cp\u003eThis study examines the perceptions of local nurses at Tiemenguan Hospital regarding nursing assistance in Xinjiang. The primary research question is: What are the views and needs of these nurses, and what factors influence their perspectives? Based on national policies, targeted assistance layouts, Hebei's support experience in Bayingolin Mongol Autonomous Prefecture, and the management of the Third Hospital of Hebei Medical University, the research investigates nurses' knowledge, influencing factors, and improvement needs. The findings will provide evidence for refining assistance training, enhancing institutional effectiveness, and retaining talent. This will promote a shift from “blood‑transfusion” to “blood‑generation” and support sustainable nursing development in frontier regions.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eGeneral information \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA purposive sampling strategy was employed, selecting participants according to their work schedules, professional status, and the principle of maximum variation\u003csup\u003e[5]\u003c/sup\u003e. Local nurses who met the inclusion criteria and worked at Tiemenguan Hospital were invited to interviews. Inclusion criteria: (1) Working at Tiemenguan Hospital, (2) Possession of a valid nursing practice licence registered at Tiemenguan Hospital, (3) Continuous employment at Tiemenguan Hospital since September 2019. Exclusion criteria: (1) Nursing assistance personnel, (2) Nurses who joined after September 2019. The sample size was determined by data saturation, which involved continuing interviews until no new themes emerged. Eight nurses were interviewed and are anonymised as N1–N8. The study received ethics approval from the Tiemenguan Hospital Ethics Committee. Participant demographics appear in Table 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDevelopment of the Interview Guide\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe interview guide used in this study was specifically developed for the present research and has not been published elsewhere. It was constructed based on a systematic literature review and iterative discussions within the research team, which included qualitative-research nursing experts from the Third Hospital of Hebei Medical University, nursing management specialists, the Director of the Nursing Assistance Department at Tiemenguan Hospital, and five local head nurses. This multi-stakeholder collaboration ensured the guide’s comprehensiveness, cultural appropriateness, and alignment with the study’s research objectives. After drafting the initial version, two local nurses (who did not participate in the formal interviews) were invited to complete pilot interviews to test the guide’s clarity and feasibility. Feedback from the pilot phase was used to refine question wording, adjust the sequence of items, and eliminate ambiguous content. The final interview guide consisted of the following five items (e.g., “Please describe your understanding of nursing assistance to Xinjiang”).\u0026nbsp;The interview guide is provided in Appendix 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData collection and quality‑control procedures\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eGuided by a descriptive phenomenological framework, data were gathered through semi-structured interviews. All interviewers were members of the nursing department, held master's degrees, and had completed formal training in qualitative research methods. Their familiarity with the hospital's various departments and the established rapport with participants facilitated a trusting environment that encouraged cooperation.\u003c/p\u003e\n\u003cp\u003eBefore each interview, the research purpose and significance were explained to the participants, and written informed consent was obtained\u003csup\u003e[6]\u003c/sup\u003e.\u0026nbsp;Interviews were conducted in the handover rooms of the respective wards, which provided a quiet and comfortable setting free from interruptions by unrelated personnel, ensuring the privacy of the interviewees.\u003c/p\u003e\n\u003cp\u003eWith full respect for each nurse's personal wishes\u003csup\u003e[7]\u003c/sup\u003e, an open-ended questioning style was employed to invite nurses to share their thoughts and prompt recollection of their six-year experience with nursing assistance in Xinjiang. Upon agreement, the entire interview was audio-recorded using a digital voice recorder, and contemporaneous field notes were taken to capture non-verbal cues, such as facial expressions and body language.\u003c/p\u003e\n\u003cp\u003eEach interview lasted between 30 and 45 minutes. The combination of audio recordings and detailed field notes enhanced the credibility of the data and supported subsequent phenomenological analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData analysis \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWithin 24 hours after each interview, the field notes and audio recordings were organized. The recordings were transcribed verbatim into Microsoft Word documents; any omissions or transcription errors were promptly verified against the original audio files. A second member of the research team independently cross-checked the transcripts for accuracy\u003csup\u003e[8]\u003c/sup\u003e. The finalized transcripts were then imported into NVivo 12 for systematic coding.\u003c/p\u003e\n\u003cp\u003eTwo researchers independently applied Colaizzi’s 7\u003csup\u003e[9]\u003c/sup\u003e phenomenological method to analyse the data and extract themes.\u003c/p\u003e\n\u003cp\u003e(1) Familiarisation– read all transcripts repeatedly to obtain a holistic sense of the material.\u003c/p\u003e\n\u003cp\u003e(2) Identifying significant statements–extract statements that directly pertain to the phenomenon under investigation.\u003c/p\u003e\n\u003cp\u003e(3) Formulating meanings–interpret the extracted statements to uncover underlying meanings.\u003c/p\u003e\n\u003cp\u003e(4) Clustering themes–group formulated meanings into theme clusters that reflect common concepts.\u003c/p\u003e\n\u003cp\u003e(5) Developing an exhaustive description – integrate the theme clusters into a comprehensive description of the lived experience.\u003c/p\u003e\n\u003cp\u003e(6) Producing the fundamental structure–distil the exhaustive description into a concise statement of the phenomenon's essence.\u003c/p\u003e\n\u003cp\u003e(7) Member checking–return the description to the participants for validation.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFollowing the analysis, the research team conducted a joint audio review session. Two researchers compared their preliminary thematic findings, discussed discrepancies, and reached consensus to ensure the credibility, accuracy, and completeness of the final dataset.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical considerations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval for this study was obtained from the Medical Ethics Committee at the research site. Before the interviews, all participants were informed of the study's aim, details, and the voluntary nature of their participation, either verbally or in writing, and then signed an electronic consent form via WeChat or email.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe study ultimately included eight local nurses, who were assigned identifiers N1–N8 according to the sequence of their interviews. By applying Colaizzi's seven‑step phenomenological analysis to compare and integrate the coded data, and through collective discussion within the research team, the final results were derived. A total of four themes and thirteen sub‑themes were extracted (Table 2).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSignificance and Value of Nursing Assistance to Xinjiang\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis theme captures local nurses’ understanding of nursing assistance in Xinjiang by emphasizing the program’s core values: advancing healthcare through technology, promoting professional growth, and providing emotional support. This summary of years of practice highlights three ways frontline nurses contribute: introducing advanced technologies, cultivating professional development, and providing emotional support to the people of Hebei and Xinjiang.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eIntroduction of Advanced Nursing Technologies \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe nursing‑assistance program of the Third Hospital of Hebei Medical University, through systematic technology introduction and department development, has markedly enhanced the medical service capacity of Tiemenguan Hospital and elevated the professional competence of its nursing staff, thereby laying a solid foundation for the sustainable development of nursing services in frontier regions.\u003c/p\u003e\n\u003cp\u003eN1, N4: Before Director Dong arrived, no operations had been performed as a brigade-level hospital. After she established the operating room, Tiemenguan Hospital entered a new chapter.\u003c/p\u003e\n\u003cp\u003eN2: Building on Director Dong's innovations, Wang Li brought the PICC technology to our hospital and taught us how to insert and care for the catheters.\u003c/p\u003e\n\u003cp\u003eN8: In 2022, Director Zheng Jun‑ting’s nursing team initiated further assistance, establishing a hemodialysis unit and a central sterile services department (CSSD). We started building the hemodialysis unit in 2022 and began using it in 2023. Now, patients no longer have to travel 100 km to Kuerle Hospital for dialysis.\u003c/p\u003e\n\u003cp\u003eN7: With these specialists, such as PICC and hemodialysis experts, we have gradually incorporated the corresponding nursing skills they introduced into our daily practice.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCultivation of Nurses’ Professional Growth\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe nursing-assistance project, by implementing systematic specialty training and diversified learning pathways, has significantly promoted the professional growth and occupational identity of nurses at Tiemenguan Hospital, thereby establishing a solid foundation for the long-term, sustainable development of the nursing workforce in frontier regions.\u003c/p\u003e\n\u003cp\u003eN7\u003cstrong\u003e:\u003c/strong\u003e After Director Zheng arrived, I was sent to Hebei to study hemodialysis specialty nursing, which I had never encountered before.\u003c/p\u003e\n\u003cp\u003eN2: Following the footsteps of the nursing‑assistance experts, I learned critical‑care specialty nursing in Hebei and obtained a specialty‑nurse certificate. This has been immensely helpful for my future career planning.\u003c/p\u003e\n\u003cp\u003eN3: The arrival of the Third Hospital’s nursing‑assistance experts gave many of our nurses the chance to pursue further study, whether at the Corps Hospital, the regional hospital, or in Hebei. These experiences broadened our horizons and elevated our nursing competence.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEmotional Support for the People of Hebei and Xinjiang\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe nursing team dispatched from the Third Hospital of Hebei Medical University not only delivered technical expertise and services but also forged an emotional bridge that links the two regions, creating a warm, “family-like” atmosphere between Hebei and Xinjiang. The support manifested through listening, encouragement, sharing, resonance, ritual, and mutual assistance.\u003c/p\u003e\n\u003cp\u003e N5: The nursing mentors sent to Xinjiang listen attentively. They take time to sit with us, discuss issues specific to Tiemenguan, and address our questions and concerns.\u003c/p\u003e\n\u003cp\u003eN8: We had never participated in skill competitions before. The assistance nurses motivated us to strive for excellence. Even without winning, we felt rewarded and fulfilled.\u003c/p\u003e\n\u003cp\u003eN4: Every Nurse's Day is celebrated spectacularly, and on each nurse’s birthday, the hospital remembers us and sends a birthday card. It adds a strong sense of ceremony. We truly feel like one big family. Although Hebei and Xinjiang are far apart, the assistance program makes the distance feel much shorter. Whenever we encounter any issues, the nursing staff is always ready to assist us.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eImplementation Outcomes of Nursing Assistance to Xinjiang\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe distinct nature of the nursing‑assistance work has prompted local nurses to discuss its outcomes from multiple perspectives, which can be grouped into three categories: dissemination of nursing techniques, improvement of systems and quality, and enhancement of patient satisfaction.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDissemination of Nursing Techniques\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUnder the guidance of the nursing assistance team, nursing techniques at Tiemenguan Hospital have been systematically disseminated across disciplines, and all interviewed nurses reported the sub-theme of nursing technology dissemination.\u003c/p\u003e\n\u003cp\u003eN8: With the increasing number of new surgeries, we have also begun to engage in related nursing procedures and skills, such as operating mechanical ventilators (machines that assist or replace spontaneous breathing), invasive arterial pressure monitoring (measuring blood pressure directly from an artery), and continuous renal replacement therapy, or CRRT (a procedure to support kidney function over an extended period).\u003c/p\u003e\n\u003cp\u003eN3: The central sterile services department was established with the assistance of nursing experts; now that it has been handed over to us, it runs smoothly. This represents a major contribution of the assistance program。\u003c/p\u003e\n\u003cp\u003eN4: During quality‑control activities, I was unfamiliar with the PDCA cycle. After guidance from the nursing assistant mentors, I learned that it is a quality management tool, and I feel that my professional competence has been enhanced.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInstitutional and Quality Improvements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eGuided by the nursing-assistance team, systematic reforms—including the streamlining of institutional procedures, standardization of documentation, unification of teaching tools, and the implementation of patient-safety-oriented quality management—have significantly enhanced the hospital’s regulatory compliance and nursing quality standards. These changes have not only rendered workflows more efficient and traceable but also fostered a culture of continuous improvement driven by quality indicators across the entire institution, thereby laying a solid foundation for the long‑term development of healthcare services in frontier regions.\u003c/p\u003e\n\u003cp\u003eN4: Previously, the hospital lacked formal written documents. After Director Zheng arrived, a complete set of nursing policies was established and subsequently adapted to the actual conditions of our hospital。\u003c/p\u003e\n\u003cp\u003eNow every department's ledger is complete, from the first folder to the last; the contents and printing format of each folder are standardized across the hospital.\u003c/p\u003e\n\u003cp\u003eN2: Currently, under the leadership of the assistant nurses, our department is required to submit data to both the national nursing quality data platform and the Corps' nursing quality database. We must meet all 25 nationally mandated sensitive indicators, which forces us to use these indicators as benchmarks and consequently raises the overall quality of nursing.\u003c/p\u003e\n\u003cp\u003e Previously, the workflow extended from start to finish, with responses occurring only when patients complained. The situation has changed: assessments are now conducted first, nursing care is provided subsequently, and patient safety is placed at the core of practice.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eImprovement in Patient Satisfaction\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe nursing-assistance team's use of dynamic evaluation, innovative health education, continuity of care, and home-visit nursing has improved patients' perceived quality of care and satisfaction. Nurses now proactively communicate, teach interactively, and provide comprehensive care. As a result, patient recognition and gratitude have increased, reinforcing the value of nursing.\u003c/p\u003e\n\u003cp\u003eNurse N8 explained, \"Previously, we would not check on patients unless they called us. Now we are required to patrol patients according to nursing grades, conduct an initial assessment on admission, and perform dynamic re-assessments, which forces us to communicate with patients more frequently.\"\u003c/p\u003e\n\u003cp\u003eN2: I used to deliver health education by simply reading from a script. With the new health‑education approach, patients now understand the information much more comprehensively. N7: Previously, we only presented banners to doctors. In our department, we now also give nurses banners, and one even bears my name!\u003c/p\u003e\n\u003cp\u003eN6: From admission to discharge, we follow a continuous care pathway. When a patient returns for a follow-up, we already know their previous diagnosis, and we greet them before they have a chance to speak.\u003c/p\u003e\n\u003cp\u003eN4: One patient informed us that your hospital offers home-visit nursing services—this is the first time I have encountered such a service in Xinjiang.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eChallenges Faced by the Nursing Assistant in Xinjiang\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe nursing-assistance program has raised nursing standards at Tiemenguan Hospital. However, local nurses reported three main challenges: increased workload and pressure, difficulties in adapting new practices to the local context, and frequent staff turnover, which caused incomplete handovers and a lack of follow-up.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eIncreased Workload and Stress\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDuring the nursing‑assistance process, nurses experienced heightened work pressure as a direct consequence of deeper systemic factors inherent to the programme.\u003c/p\u003e\n\u003cp\u003e The hospital is striving to achieve a secondary‑grade status, which requires the collection of numerous indicators. Because we lacked an information management system, it was difficult to handle, and the pressure felt during that period was immense.\u003c/p\u003e\n\u003cp\u003e To improve patient-safety indicators, the hospital set higher pass-rate targets for nursing-quality metrics, such as pressure injuries, falls, and thrombosis. Significant efforts were made to meet these rates, and at times, it was exhausting.\u003c/p\u003e\n\u003cp\u003eN4: The number of newly established departments is increasing, and the case mix is becoming more complex. Occasionally, we are short-staffed, so we have to support multiple wards, ensure coverage, and also take on teaching responsibilities. It feels as if I have been split into several people, while still having children at home。\u003c/p\u003e\n\u003cp\u003eN4: Although the workload has increased dramatically, it is mainly because we were previously too relaxed, so the fatigue is more noticeable now。 \u003c/p\u003e\n\u003cp\u003eN1: This is also a necessary path for improving professional competence and advancing local nursing standards. If we don’t learn now, when will we?\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDifficulty of Local Adaptation\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe nursing-assistance project faces significant challenges in localizing its technologies and management systems, aligning national quality indicators with the hospital's actual workload, building research capacity, and matching specialist nurse positions. These issues constrain the effective translation and sustained advancement of advanced nursing practices at Tiemenguan Hospital.\u003c/p\u003e\n\u003cp\u003eN1: The nursing department requires that hemodialysis data be collected and reported to the Corps and the national health authorities. The Third Hospital has an information system in place to automate this process, but the hemodialysis unit at Tiemenguan Hospital is a newly established unit and lacks such a system. We must rely on manual statistics, which are cumbersome and prone to errors, yet the reports cannot be omitted。\u003c/p\u003e\n\u003cp\u003eN3：Under the direction of the nursing department, our hospital joined the national nursing data quality platform in 2024 and is now required to submit sensitive nursing indicators. The Third Hospital is a tertiary-grade institution, whereas we are a secondary-grade hospital with a much smaller patient volume. For indicators such as the incidence of tracheal extubation, we have virtually no cases, resulting in many data points being zero, which can be perceived as meaningless. Similarly, for central‑venous catheter infection rates, the hospital lacks the capacity for bacterial cultures, so those figures are also zero。\u003c/p\u003e\n\u003cp\u003eN7: We are encouraged to conduct research, publish articles, and write reviews. I understand this is meant to develop research thinking. However, I have no experience with manuscripts or CNKI. Promotion here does not require publications, but learning research skills could still support growth and broaden perspectives. Despite this, I am still hesitant to invest effort.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFrequent Turnover of Assistance Staff, Incomplete Handover, and Lack of Follow-up\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe high turnover of nursing-assistance personnel creates compressed handover periods and incomplete information transfer, which in turn lead to a series of problems: specialization bias, frequent changes in management approaches, and a lack of post-implementation follow-up. These interrelated factors undermine the continuity and sustainability of the assistance program, thereby compromising the long-term impact on nursing quality improvement at Tiemenguan Hospital.\u003c/p\u003e\n\u003cp\u003eSince 2019, each newly appointed cohort of nursing assistant teachers has had only a few days for handover, which restricts thorough explanation of hospital practices and hinders transition efficiency.\u003c/p\u003e\n\u003cp\u003eN1: Each assistance nurse has a different specialty. Some teachers have a broad skill set and can, over the course of a year, improve the overall nursing management at Tiemenguan Hospital. Others are highly specialized and are less adept in other areas, resulting in a bias toward their own field during their tenure。\u003c/p\u003e\n\u003cp\u003eWhen a teacher prefers one management style and the incoming teacher prefers another, the management approach shifts completely after handover. This abrupt change presents difficulties for the team in adapting.\u003c/p\u003e\n\u003cp\u003eWithout a comprehensive handover, new assistant nurses spend valuable assignment time familiarizing themselves with the hospital, limiting their ability to implement changes quickly within the one-year period.\u003c/p\u003e\n\u003cp\u003eN3: The hospital lacks a continuous tracking platform. After an assistant nurse departs, no one monitors whether the professional or managerial level she was responsible for has improved or declined。\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eExpectations and Recommendations for Nursing Assistance to Xinjiang\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAs the direct beneficiaries of the nursing‑assistance program, local nurses possess firsthand recommendations and unique perspectives on nursing assistance. Interviewing them to gather suggestions for improving the program is of great value for more effective implementation of nursing assistance and for enhancing the nursing standards of frontier hospitals.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLooking Forward to Continued Dispatch of Nursing Assistance Personnel\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInterviewees believe that nursing assistance should be coordinated with medical assistance, maintaining long‑term, complementary personnel dispatches to ensure the continuity and overall effectiveness of the assistance program.\u003c/p\u003e\n\u003cp\u003eBuilding on this perspective, N1 explains that medical assistance alone is insufficient; without parallel nursing support, the entire system will break down.\u003c/p\u003e\n\u003cp\u003eEchoing this sentiment, N2 states that they hope nursing instructors will continue to be dispatched for assistance; otherwise, previous efforts may be felt as wasted.\u003c/p\u003e\n\u003cp\u003eN4 emphasizes that nursing should develop in tandem with medical services; when specialist medical experts are dispatched, corresponding nursing specialists should also be sent to ensure joint advancement.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRecommendation for the Third Hospital of Hebei Medical University to Dispatch Nursing‑Assistance Personnel According to the Departmental Structure of Tiemenguan Hospital\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInterviewees expressed that the Third Hospital of Hebei Medical University should align its nursing‑assistance dispatches with the departmental structure of Tiemenguan Hospital, targeting the deployment of specialist nursing personnel to achieve rapid capacity building and sustainable development of each department.\u003c/p\u003e\n\u003cp\u003eN1: The hemodialysis unit, under the guidance of the nursing assistant staff, has been developed into a high‑quality department that resembles a tertiary‑grade ward; this outcome is highly satisfactory.\u003c/p\u003e\n\u003cp\u003eN2: I hope that when the Third Hospital sends staff again, a dedicated nurse for the interventional suite can be dispatched. With a one-year effort to establish the interventional suite, the hospital’s overall condition will gradually improve, just as the hemodialysis and sterilization units were previously built.\u003c/p\u003e\n\u003cp\u003eN6: The hemodialysis and sterilization units serve as typical examples; if a specialist nurse for orthopaedics is sent next year, the nursing and management standards of the orthopaedic department will be elevated accordingly.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eImproving the Handover of Nursing‑Assistance Personnel to Prevent Restarting\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBy standardizing handover documentation, detailing the content of handovers, ensuring continuity of professional development, and appropriately managing interpersonal relationships, the quality of nursing-assistance handovers can be significantly improved, preventing redundant restarts and ensuring that assistance work proceeds continuously and smoothly.\u003c/p\u003e\n\u003cp\u003eN5: Standardize all materials and documents provided annually by the nursing-assistance instructor to match those of the Third Hospital. This will prevent incoming instructors from having to face the cumbersome task of revising all materials.\u003c/p\u003e\n\u003cp\u003eDuring handover, the nursing‑assistance instructor must deliver a detailed shift report. This report should identify each nurse’s development stage, each department’s shortcomings, and any adverse departmental culture. It must also note which nurses have been specifically cultivated for managerial capacity and could be groomed as future head nurses. All of this information needs to be transferred.\u003c/p\u003e\n\u003cp\u003eN7: Address training inequities by ensuring that specialist nurse training records are transferred during handover. This prevents new instructors from assigning duplicate or unnecessary specialty training.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRecommendation to Establish a Nursing‑Assistance Tracking Platform to Institutionalize Communication and Follow‑Up Across Cohorts of Nursing‑Assistance Personnel\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo realize these benefits, actively implement an information technology platform, maintain stable management, and foster ongoing technical exchanges to address poor handovers, repetitive work, and loss of experience. Take these actions to support nursing care in frontier regions, enhance teamwork among medical and nursing staff, and drive meaningful improvements in healthcare quality in Xinjiang.\u003c/p\u003e\n\u003cp\u003eEstablish an online platform and begin holding regular meetings with previous nursing-assistance instructors to review past work and plan ahead. Take the initiative to organize these meetings and solicit input from all participants.\u003c/p\u003e\n\u003cp\u003eN3: After the assistance instructors leave, there should be a timely follow‑up to see whether the work they carried out has been sustained. If it has not been implemented, who should be contacted for further information? Who should be consulted? This is lacking because the instructor’s expertise is best understood by herself.\u003c/p\u003e\n\u003cp\u003eN4: When the assistance instructors depart, can we continue to communicate with the Third Hospital? If we want to keep attending courses offered by the Third Hospital, whom should we approach? This needs to be arranged before they leave, with a clear plan in place.\u003c/p\u003e\n\u003cp\u003eN5: From the hospital’s perspective, a formal system should be established to standardize the duties of nursing‑assistance instructors, especially concerning handover procedures and subsequent follow‑up.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003e This qualitative study involved eight local nurses who had each participated in a six-year nursing assistance program. The majority of participants considered nursing assistance to be an effective strategy for enhancing the quality of nursing care in their hospitals. The nurses recounted their personal experiences and identified the activities they considered most valuable within the nursing-assistance framework\u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e. Findings indicate that nursing assistance has a positive influence on the professional development of local nurses, enhances technical competencies, and fosters stronger inter-provincial relationships. Nevertheless, several implementation challenges emerged during the programme. Based on the interview data, the participants offered a series of recommendations aimed at optimizing nursing-assistance policies to further strengthen the sustainability and impact of the initiative\u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eExploring the Value of Nursing Assistance in Xinjiang for Technological Advancement, Professional Development of Nurses, and Emotional Bonding at Tiemenguan Hospital\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe implementation of nursing assistance at Tiemenguan Hospital has provided local nurses with the most immediate benefit: the introduction of advanced nursing technologies, particularly over the past six years. This study demonstrates that the establishment of an operating theatre provided a hardware platform for subsequent high-risk surgeries, while the creation of a central sterile services department ensured logistical support for surgical safety. The introduction of mechanical ventilation and endotracheal intubation techniques further expanded the scope of critical-care nursing, forming a positive \u0026ldquo;technology-chain\u0026rdquo; cycle. The launch of a hemodialysis unit directly alleviated the burden of patients traveling 100 km across regions, markedly improving patients' well-being and quality of life\u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eAlthough the technological introductions achieved notable outcomes, constraints in equipment configuration and staff experience necessitate further localization through on‑the‑job training and standardized operating procedures. Multiple interviewees repeatedly emphasized this adaptation process, suggesting that future research should explore the key success factors of technology transfer\u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e. Quantitative data indicate that from 2019 to 2025, nursing‑assistance personnel trained 25 specialist nurses, demonstrating a \u0026ldquo;seed\u0026rdquo; effect of the program on the development of a professional talent pipeline\u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eInterviewees highlighted a range of specialties\u0026mdash;including critical care, emergency, operating theatre, hemodialysis, PICC line placement, wound ostomy care, geriatric nursing, traditional Chinese medicine, and central sterile services\u0026mdash;that have markedly deepened the professional expertise of the nursing team at Tiemenguan Hospital. Through external training programs and the acquisition of specialist nurse certifications, nurses have established clear career development pathways, thereby strengthening their professional identity.\u003c/p\u003e \u003cp\u003eThe establishment of eight dedicated specialty groups has provided nurses with specialized work platforms, facilitating systematic knowledge management and the transmission of expertise. This organizational structure contributes to the formation of a \u0026ldquo;learning organization,\u0026rdquo; which, in turn, enhances overall nursing quality and effectiveness. Opportunities for professional growth are typically positively correlated with nurses' intentions to remain in their profession. Over the past five years, only five nurses have left Tiemenguan Hospital, while the total nursing staff has increased from 23 in 2019 to 96 in 2025. High-quality nursing talent from multiple corps-affiliated and local hospitals has flowed into Tiemenguan Hospital, indicating the institution\u0026rsquo;s strong appeal for nurses\u0026rsquo; career prospects.\u003c/p\u003e \u003cp\u003eThese favorable evaluations from local nurses demonstrate that nursing assistance has played an active role in attracting talent and reducing turnover at Tiemenguan People's Hospital. Going forward, the hospital should continue to align talent recruitment and retention strategies with its disciplinary development, actively introducing new technologies to sustain and further enhance its nursing capacity.\u003c/p\u003e \u003cp\u003e In addition to the technical and career-building aspects, interviewees repeatedly emphasized the importance of emotional interactions\u0026mdash;such as listening, encouragement, sharing, and ritualized activities\u0026mdash;which are especially critical in cross-regional assistance. Symbolic events such as International Nurses Day celebrations and birthday cards create a sense of \u0026ldquo;family-like\u0026rdquo; warmth for the assisted nurses, thereby strengthening team belonging. This emotional support is regarded as \u0026ldquo;emotional capital\u003csup\u003e[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e\u0026rdquo;, helping to sustain motivation in resource-constrained settings. Nursing-assistance experts provide narrative-care opportunities that allow nurses to express work-related stress and emotional experiences, enhancing psychological safety and indirectly improving nursing quality\u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThrough attentive listening to local needs and sharing nursing practices from Hebei, the assistance experts foster bidirectional learning and cultural complementarity, establishing a \u0026ldquo;Hebei-Xinjiang family\u0026rdquo; social network. Such a network facilitates rapid information flow, resource sharing, and offers a replicable emotional model for future assistance initiatives in other regions\u003csup\u003e[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003e \u003cb\u003eComprehensive Effects of Nursing Assistance in Xinjiang on Technological Dissemination, Institutional Quality Improvement, and Patient Satisfaction at Tiemenguan Hospital\u003c/b\u003e \u003c/p\u003e \u003cp\u003eInterviewees consistently reported that nursing-assistance experts helped the hospital create a complete nursing management system, standardize documentation templates, develop a quality-data reporting framework, and design patient-safety-oriented workflows. The transition was significant: the hospital moved from \"no formal written materials\" to a \"hospital-wide unified filing system.\" This change highlights a key outcome: building institutional structures standardizes organizational behavior\u003csup\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/sup\u003e. Furthermore, uniform procedures increase work efficiency and supply foundational data for later quality monitoring. In turn, reporting to the national nursing quality data platform and the Corps\u0026rsquo; nursing quality database requires the hospital to meet 25 sensitive indicators. This external driver subsequently raises internal standards[\u003csup\u003e[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/sup\u003e. Additionally, standardizing PPT templates and case-discussion formats regularizes teaching and research. As a result, the quality of knowledge dissemination improves.\u003c/p\u003e \u003cp\u003ePatients moved from \"no complaints, no inquiries\" to \"active communication, dynamic assessment, and home-visit services.\" This shift reflected a qualitative leap in satisfaction\u003csup\u003e[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/sup\u003e. Similarly, care changed from \"executing medical orders\" to \"nursing-level rounds, health education, and continuous follow-up,\" showing an evolution in nursing service philosophy. Furthermore, nurse-presented banners and home-visit services reinforced emotional care and added a \"finishing touch\" to patient satisfaction. Nurses memorized the inpatient-to-outpatient-to-follow-up pathway and proactively contacted patients, creating a \"closed-loop\" nursing model that markedly increased patients' trust in the hospital.\u003c/p\u003e \u003cp\u003eIn resource-constrained frontier regions, emotionally oriented, continuous nursing interventions can compensate for limited hardware facilities\u003csup\u003e[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003e. It is therefore recommended that such practices be institutionalized and incorporated into nursing quality evaluation systems. Purely technical transfer or reliance on institutional construction alone is insufficient to achieve sustainable nursing improvement in remote, under-resourced settings\u003csup\u003e[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003e. Rapid technology dissemination requires the safeguarding of standardized procedures, while emotional connection is essential for maintaining team cohesion and enhancing patient satisfaction. The three elements\u0026mdash;technology, institutionalization, and emotional linkage\u0026mdash;mutually reinforce one another, forming a triadic support model that ensures the enduring impact of nursing assistance in the local context.\u003c/p\u003e \u003cp\u003e \u003cb\u003eWorkload, Local Adaptation, and Handover Tracking: Three Major Challenges of Nursing Assistance in Xinjiang and Their Mitigation Strategies\u003c/b\u003e \u003c/p\u003e \u003cp\u003eInterviewees N1 and N2 reported that to obtain secondary-grade hospital accreditation and meet patient-safety indicators (pressure injuries, falls, thrombosis, etc.), hospitals must collect substantial data. Without an information technology system, staff collect and analyze all data manually, which increases their workload. The hemodialysis unit also lacks an information system and must manually compile specialty indicators, increasing the risk of errors and adding to the workload.\u003c/p\u003e \u003cp\u003eN3 further pointed out that the sensitive indicators required by the national nursing quality platform are difficult to report for a Level II hospital, where the patient base is small and cases are scarce. Because of this small patient base and limited cases, many \u0026ldquo;zero-value\u0026rdquo; entries are generated, thereby weakening the data's significance. Specialist nurses find it hard to play a role locally, as their limited research-writing skills prevent them from completing the required papers or reviews. This skill gap leads to low research motivation among nurses. Efforts to improve quality inevitably increase work pressure. Indicator-driven improvement is essential for nursing quality; however, without a supporting digital platform, nurses are pulled away from clinical care for heavy documentation, which may compromise clinical safety\u003csup\u003e[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eTo address these issues, take these measures. First, deploy lightweight data-collection tools in key departments, then expand hospital-wide\u003csup\u003e[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/sup\u003e. Second, within the national platform, develop \u0026ldquo;localized indicator thresholds\u0026rdquo; for Level II hospitals\u0026mdash;for example, use \u0026ldquo;case rate per bed\u0026rdquo; rather than absolute numbers\u0026mdash;to avoid statistical distortion from zero values\u003csup\u003e[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/sup\u003e. Third, establish a \u0026ldquo;research starter group\u0026rdquo; that understands local nurses\u0026rsquo; needs; invite research mentors from the Third Hospital of Hebei Medical University to provide online or offline guidance, including templates, literature search training, and CNKI workshops \u003csup\u003e[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/sup\u003e. Finally, assign certified specialist nurses as \u0026ldquo;specialty consultants\u0026rdquo; to provide technical guidance and training rather than routine bedside care, leveraging their expertise.\u003c/p\u003e \u003cp\u003eInterviewees identified three main handover issues: insufficient time, mismatched specialties, and the lack of a tracking platform. To address these: (1) Begin handover preparation one month before annual turnover, including a two-week \"hand-over internship\" for outgoing and incoming nurses to ensure thorough knowledge transfer\u003csup\u003e[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/sup\u003e. (2) Implement a rotation schedule, enabling each group of assistance nurses to work in all critical departments and prevent specialty bias. (3) Establish a project progress tracking process where local nursing supervisors and assistant project leaders assess handover implementation and produce improvement reports.\u003c/p\u003e \u003cp\u003eNursing assistance is a systematic endeavor; the three major challenges\u0026mdash;workload, local adaptation, and handover tracking\u0026mdash;are interwoven. Addressing only one of them rarely leads to fundamental improvement in the assistance outcomes. The above recommendations can be compiled into a \u0026ldquo;Nursing Assistance Project Management Manual,\u0026rdquo; which can be disseminated to other remote‑area assistance projects nationwide to achieve standardized replication of experience.\u003c/p\u003e \u003cp\u003eNevertheless, an important issue remains: the assisting hospitals face constraints in personnel, finances, and material resources\u003csup\u003e[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eAnalysis of Policy‑Level Recommendations for Implementing Nursing Assistance in Xinjiang\u003c/h2\u003e \u003cp\u003eThe Corps Nursing Society and assisting provinces\u0026rsquo; societies should create a unified \u0026ldquo;Nursing Assistance Data Platform\u0026rdquo; for Xinjiang\u003csup\u003e[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]\u003c/sup\u003e, This platform would coordinate nursing assistance across hospitals and regions, increasing efficiency, transparency, and resource sharing. Its main functions include: (1) Submitting and coordinating nursing-specialty needs; (2) Assessing and evaluating nursing-assistance projects; (3) Reporting and tracking work hand-overs for nursing assistance.\u003c/p\u003e \u003cp\u003eTo further enhance coordination, refine the bilateral assistance agreement to add hardware, software, IT, research, personnel handover, and workload provisions. This will establish an integrated management framework[\u003csup\u003e[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eTo strengthen local adaptation, a \u0026ldquo;Local-Adaptation Working Group\u0026rdquo; should be created\u003csup\u003e[\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]\u003c/sup\u003e, This group should comprise experts from the partner hospitals and local medical staff. Each technology, indicator, and system would be customized locally before rollout.\u003c/p\u003e \u003cp\u003eTwo additional recommendations for future initiatives are as follows: (1) Expand the involvement of nursing-assistance experts beyond recipient hospitals to include a tertiary hospital within the same jurisdiction, thereby leveraging the strengths of nursing assistance and enabling high-quality nursing resources from Hebei Province to advance both the local tertiary hospital and the recipient hospital\u003csup\u003e[\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]\u003c/sup\u003e. (2) Prioritize assistance to the local tertiary hospital in Xinjiang to reduce disparities between Xinjiang and other regions. Once the local tertiary hospital is strengthened, it can serve as a hub for an intra-regional assistance model, supporting secondary hospitals within Xinjiang\u003csup\u003e[\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eStrengths and Limitations\u003c/h2\u003e \u003cp\u003eA key strength of this study lies in the fact that all participants are local nurses who have been involved in the nursing assistance program since its inception six years ago. This long-term engagement enables them to provide highly authentic and direct feedback on their experiences. As one of the first qualitative studies focusing on nursing assistance initiatives in Xinjiang, China, this research addresses a gap in the systematic exploration of this specific field. TwoThese favorable evaluations demonstrate that nursing assistance has played an active role in attracting talent and reducing turnover. Going forward, the hospital should continue to align talent recruitment and retention strategies with its disciplinary development limitations of the study should be acknowledged. First, the representativeness of the sample is constrained. All interviewees were recruited from a single recipient hospital, which operates under the entrustment of the Third Hospital of Hebei Medical University and has developed a distinct assistance model through long-term collaborative efforts. Consequently, the conclusions drawn may not be generalizable to hospitals that are independently managed or receive assistance from other provinces. Second, there are constraints related to geographical scope and applicability. Xinjiang is a geographically extensive region, and substantial variations exist in medical resource allocation and assistance models across hospitals in different areas. Therefore, the recommendations proposed in this study may not be fully applicable to remote regions or hospitals at different stages of development.\u003c/p\u003e \u003cp\u003eDespite these limitations, this study still offers valuable insights into nursing assistance practices in Xinjiang, which can inform the optimization of future assistance programs.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis qualitative study offers new insights for provinces participating in nationwide nursing assistance programs, highlighting both the experiences gained and the challenges encountered during implementation. The findings underscore that nursing assistance not only introduces novel clinical techniques to nurses but also fosters their professional development and strengthens the bonds between the people of Hebei and Xinjiang. As a pioneering effort to investigate nursing assistance in China, the study emphasizes the initiative\u0026rsquo;s pivotal role within the broader strategy of balanced development between the eastern and western regions, illustrating the importance and exploratory nature of health-care assistance in Xinjiang.\u003c/p\u003e \u003cp\u003eNursing assistance has evolved into a tri-dimensional model integrating three key elements: technology, talent, and emotional connection. These, supported by institutional mechanisms, reinforce one another across four interrelated areas. This integrated approach has improved nursing quality in frontier hospitals.\u003c/p\u003e \u003cp\u003eTo achieve sustainable and standardized outcomes, the three core challenges\u0026mdash;workload, local adaptation, and handover tracking\u0026mdash;must be addressed concurrently, and policy measures should focus on:(1) Building a unified data platform for nursing assistance. (2) Refining bilateral assistance agreements. (3) Expanding the scope of assistance.\u003c/p\u003e \u003cp\u003eFuture research should use mixed-methods designs. It should conduct longitudinal comparative analyses across different assisting hospitals and recipient regions. Researchers should also test whether the current findings are generalizable and sustainable in the long term. Such work will provide an evidence-based foundation for scaling nursing assistance in China.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe thank all departments and all participants for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analysed during the current study are not publicly available due to the participant confidentiality, but are available from the corresponding author on reasonable re-quest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor details\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e1\u003c/sup\u003eThe Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050000, China\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e2\u003c/sup\u003eHebei Medical University, Shijiazhuang, Hebei, China\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e3\u003c/sup\u003eTiemenguan Hospital (Affiliated with The Third Hospital of Hebei Medical University), Tiemenguan, Xinjiang, 841007, China\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;The study was conducted in accordance with the Declaration of Helsinki (2024 revision) and the International Ethical Guidelines for Health-related Research Involving Humans. This study was approved by the Ethics Committee of Hebei Medical University Third Hospital Tiemenguan City People\u0026apos;s Hospital. Written informed consent was obtained from all participants.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eKanbur R, Wang Y, Zhang XJCDP: \u003cstrong\u003eThe Great Chinese Inequality Turnaround\u003c/strong\u003e. 2017\u003c/li\u003e\n\u003cli\u003eXu G, Zhang J, Xie M, Du H, Guo M: \u003cstrong\u003eBeijing\u0026apos;s paired assistance program: Mitigating vulnerability, fostering development, and promoting equality in its ecological conservation areas\u003c/strong\u003e. \u003cem\u003ePloS one \u003c/em\u003e2025, \u003cstrong\u003e20\u003c/strong\u003e(5):e0324817\u003c/li\u003e\n\u003cli\u003eLu Z, Deng XJMP: \u003cstrong\u003eChina\u0026apos;s Western Development Strategy: Policies, Effects and Prospects\u003c/strong\u003e. \u003cem\u003eMPRA Paper \u003c/em\u003e2011\u003c/li\u003e\n\u003cli\u003eWang Q, Tian Z, Zhu SJPO: \u003cstrong\u003ePaired assistance and poverty alleviation: Experience and evidence from China\u003c/strong\u003e. 2024, \u003cstrong\u003e19\u003c/strong\u003e(3)\u003c/li\u003e\n\u003cli\u003eGao K, Zhang S, Liu J, Zhang F, Liu N, Dong J, Zhang T, Gao J, Qin S, An JJSR: \u003cstrong\u003eSupportive care needs of the family caregivers of urostomy patients: a qualitative study\u003c/strong\u003e. \u003cem\u003eScientific Reports \u003c/em\u003e2025, \u003cstrong\u003e15\u003c/strong\u003e(1)\u003c/li\u003e\n\u003cli\u003eVaismoradi M, Turunen H, Bondas T: \u003cstrong\u003eContent analysis and thematic analysis: Implications for conducting a qualitative descriptive study\u003c/strong\u003e. \u003cem\u003eNursing \u0026amp; 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Perceptions of Documentation in the Electronic Health Record: Multimethod Analysis\u003c/strong\u003e. \u003cem\u003eJMIR nursing \u003c/em\u003e2025, \u003cstrong\u003e8\u003c/strong\u003e(-):e69651\u003c/li\u003e\n\u003cli\u003ePatterson J, Worku B, Jones D, Clary A, Ramaswamy R, Bose C: \u003cstrong\u003eEthiopian Pediatric Society Quality Improvement Initiative: a pragmatic approach to facility-based quality improvement in low-resource settings\u003c/strong\u003e. \u003cem\u003eBMJ open quality \u003c/em\u003e2021, \u003cstrong\u003e10\u003c/strong\u003e(1):-\u003c/li\u003e\n\u003cli\u003eDubois RW, Brook RH, Rogers WH: \u003cstrong\u003eAdjusted hospital death rates: a potential screen for quality of medical care\u003c/strong\u003e. \u003cem\u003eAmerican journal of public health \u003c/em\u003e1987, \u003cstrong\u003e77\u003c/strong\u003e(9):1162-1166\u003c/li\u003e\n\u003cli\u003eAbraham J, Kannampallil T, Brenner C, Lopez KD, Almoosa KF, Patel B, Patel VL: \u003cstrong\u003eCharacterizing the structure and content of nurse handoffs: A Sequential Conversational Analysis approach\u003c/strong\u003e. \u003cem\u003eJournal of biomedical informatics \u003c/em\u003e2016, \u003cstrong\u003e59\u003c/strong\u003e:76-88.https://dx.doi.org/10.1016/j.jbi.2015.11.009\u003c/li\u003e\n\u003cli\u003eChen B, Lin JY: \u003cstrong\u003eDevelopment strategy, resource misallocation and economic performance\u003c/strong\u003e. \u003cem\u003eStructural Change and Economic Dynamics \u003c/em\u003e2021, \u003cstrong\u003e59\u003c/strong\u003e:612-634.https://dx.doi.org/https://doi.org/10.1016/j.strueco.2021.10.003\u003c/li\u003e\n\u003cli\u003eMak V, Brand G, Morphet J: \u003cstrong\u003eDevelopment of the quality improvement collaborative questionnaire (QuIC) to explore quality improvement partnerships to teach pre-registration nursing students\u003c/strong\u003e. \u003cem\u003eContemporary nurse \u003c/em\u003e2025, \u003cstrong\u003e61\u003c/strong\u003e(3):228-241\u003c/li\u003e\n\u003cli\u003eLee JE, Perkins J, Barnett ME, Sarpong D, Sung J: \u003cstrong\u003eImportance of capacity assessment for an early-stage research network designed to eliminate health disparity: lessons from RTRN\u003c/strong\u003e. \u003cem\u003eEthnicity \u0026amp; disease \u003c/em\u003e2010, \u003cstrong\u003e20\u003c/strong\u003e(1 Suppl 1):S1-150-154\u003c/li\u003e\n\u003cli\u003eAmp ZX, Xiaodong MJSeiN: \u003cstrong\u003eFrom \u0026quot;the Counterpart Support\u0026quot; to \u0026quot;the Collaborative Development\u0026quot;: Enlightenment of the Collaborative Governance Model\u003c/strong\u003e. Social events in Nanjing\u003c/li\u003e\n\u003cli\u003eXiong B, Bailey DX, Stirling C, Prudon P, Martin-Khan M: \u003cstrong\u003eIdentification of implementation enhancement strategies for national comprehensive care standards using the CFIR-ERIC approach: a qualitative study\u003c/strong\u003e. \u003cem\u003eBMC Health Services Research \u003c/em\u003e2024, \u003cstrong\u003e24\u003c/strong\u003e(1):974\u003c/li\u003e\n\u003cli\u003eQiu T, Luo B, Li YJC: \u003cstrong\u003eEconomic performance of the pairing-off poverty alleviation between China\u0026apos;s cities\u003c/strong\u003e. \u003cem\u003eCities \u003c/em\u003e2024, \u003cstrong\u003e152\u003c/strong\u003e(000):17\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1 \u0026nbsp;Demographic characteristics of interview participants (\u003cem\u003en\u003c/em\u003e = 8)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"794\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eID\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSEX\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAGE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYears at Hospital\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eProfessional\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 165px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 208px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSpecialist‑Nurse Status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eN1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e2019.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eSenior Nurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003eassociate degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eN2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e2011.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eSenior Nurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003eBachelor\u0026rsquo;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eN3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e2019.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eSenior Nurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003eBachelor\u0026rsquo;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eN4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e2011.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eSenior Nurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003eBachelor\u0026rsquo;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eN5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e2019.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eSenior Nurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003eBachelor\u0026rsquo;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eN6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e2019.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003eBachelor\u0026rsquo;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eN7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e2019.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003eBachelor\u0026rsquo;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eN8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e2019.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 137px;\"\u003e\n \u003cp\u003eBachelor\u0026rsquo;s degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 236px;\"\u003e\n \u003cp\u003eY\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2 Real Experiences of Local Nurses at Tiemenguan Hospital with Nursing Assistance in Xinjiang\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"width=\"897\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 277px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eThemes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 621px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSubthemes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 277px;\"\u003e\n \u003cp\u003eSignificance and Value of Nursing Assistance to Xinjiang\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 621px;\"\u003e\n \u003cp\u003eIntroduction of Advanced Nursing Technologies\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 621px;\"\u003e\n \u003cp\u003eCultivation of Nurses\u0026rsquo;Professional Growth\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 621px;\"\u003e\n \u003cp\u003eEmotional Support for the People of Hebei and Xinjiang\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 277px;\"\u003e\n \u003cp\u003eImplementation Outcomes of Nursing Assistance to Xinjiang\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 621px;\"\u003e\n \u003cp\u003eDissemination of Nursing Techniques\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 621px;\"\u003e\n \u003cp\u003eCultivation of Nurses\u0026rsquo;Professional Growth\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 621px;\"\u003e\n \u003cp\u003eImprovement in Patient Satisfaction\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 277px;\"\u003e\n \u003cp\u003eChallenges Faced by the Nursing Assistance to Xinjiang\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 621px;\"\u003e\n \u003cp\u003eIncreased Workload and Stress\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 621px;\"\u003e\n \u003cp\u003eDifficulty of Local Adaptation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 621px;\"\u003e\n \u003cp\u003eFrequent Turnover of Assistance Staff, Incomplete Handover, and Lack of Follow‑up\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" style=\"width: 277px;\"\u003e\n \u003cp\u003eExpectations and Recommendations for Nursing Assistance to Xinjiang\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 621px;\"\u003e\n \u003cp\u003eLooking Forward to Continued Dispatch of Nursing Assistance Personnel\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 621px;\"\u003e\n \u003cp\u003eRecommendation for the Third Hospital of Hebei Medical University to Dispatch Nursing‑Assistance Personnel According to the Departmental Structure of Tiemenguan Hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 621px;\"\u003e\n \u003cp\u003eImproving the Handover of Nursing‑Assistance Personnel to Prevent Restarting\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 621px;\"\u003e\n \u003cp\u003eRecommendation to Establish a Nursing‑Assistance Tracking Platform to Institutionalize Communication and Follow‑Up Across Cohorts of Nursing‑Assistance Personnel\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Nursing, Assistance to Xinjiang, Local nurses, Qualitative research","lastPublishedDoi":"10.21203/rs.3.rs-8075197/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8075197/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective:\u003c/strong\u003e To explore the perceptions and experiences of local nurses at Tiemenguan Hospital in Xinjiang regarding nursing assistance to the region, and to examine its impact on nursing work and hospital development.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eSemi-structured, in-depth interviews were conducted with eight local nurses who worked at Tiemenguan Hospital from September 2019 to September 2025. Purposeful sampling was used to capture authentic experiences, and the Colaizzi seven-step method was applied to analyze, extract, and synthesize the interview data.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eAfter repeated reading and coding, four major themes and 13 sub-themes were identified: (1) The significance and value of nursing assistance to Xinjiang; (2) The implementation effects of nursing assistance to Xinjiang; (3) The obstacles faced by nursing assistance to Xinjiang; (4) Future expectations for nursing assistance to Xinjiang.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eBased on the experiences of local nurses in this study, nursing assistance to Xinjiang plays a crucial role in enhancing nursing standards at grassroots hospitals and supporting hospital development. However, its sustainability is limited by staff turnover and institutional challenges. It is recommended to deepen assistance through institutionalization, platform-building, and specialization, thereby achieving “assistance that goes beyond technology and sustains itself locally.”\u003c/p\u003e","manuscriptTitle":"Summary of Nursing Assistance to Xinjiang Experience: A Qualitative Study (2019–2025) of Local Nurses at Tiemenguan People's Hospital, Xinjiang","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-22 08:42:36","doi":"10.21203/rs.3.rs-8075197/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewersInvited","content":"","date":"2025-12-18T07:48:11+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-12-17T05:25:40+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-11-18T08:22:13+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-11-17T11:00:28+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nursing","date":"2025-11-17T10:56:37+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"922a10ce-9096-49e2-b0be-62dadeff01ef","owner":[],"postedDate":"December 22nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-12-22T08:42:36+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-22 08:42:36","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8075197","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8075197","identity":"rs-8075197","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}