Objective  To explore the effect of constructing the "nursing assistance via the internet" mode for the elderly with chronic diseases dominated by specialist nurses and its implementation.

  Methods  Through multidisciplinary collaboration, a multidisciplinary nursing team led by specialized nurses was established and implemented. Implementation conditions of "nursing assistance via the internet" for chronic diseases in the elderly, satisfaction of patients and nurse professional identity were evaluated.

  Results  "Nursing assistance via the internet" was carried out in 69 patients, with a total of 147 times of service, including 21 cases of peripherally inserted central catheter (PICC) and infusion port maintenance, 17 cases of basic nursing operation, 11 cases of chronic health education, 8 cases of chronic wound dressing change, 7 cases of rehabilitation nursing and 5 cases of hospice care. Patients'satisfaction with "nursing assistance via the internet" was higher than 94.0%. After the implementation of the model, the nurses'sense of mastery, self-efficacy, sense of meaning, sense of consistency, sense of self-determination and the total mean score of all dimensions were significantly higher than before implementation (P < 0.05).

  Conclusion  The mode of "nursing assistance via the internet" led by specialized nurses can meet the diversified and professional home care needs of the elderly with chronic diseases, and reduce the readmission rate of patients. In addition, this model not only improves patients'satisfaction, but also enhances nurses'professional identity.