Medical subjects and genera. Including respiratory medicine, gastroenterology, cardiovascular medicine, neurology, oncology, endocrinology, hematology, infectious diseases, pediatrics and so on. Medical consultation respiratory medicine: including cold, pneumonia, emphysema, tuberculosis, bronchiectasis, asthma, lung cancer, cor pulmonale, respiratory failure, chronic bronchitis, pneumothorax, lung abscess, pleural effusion, interstitial lung disease and other diseases. The following is the knowledge I brought to you on how to effectively prevent the hidden dangers of nursing safety in respiratory medicine. Welcome to reading.
1. Common unsafe nursing factors in respiratory wards
1. 1 technical aspects. New nurses' professional knowledge is not solid, their technical level is low, their experience is insufficient, and their cooperation ability is poor, which may lead to unsuccessful venipuncture, untimely red light response and untimely disposal. Furthermore, with the introduction and development of new technologies and projects, the technical complexity and requirements in nursing work are higher, which not only brings greater work pressure to nursing staff, but also may lead to an increase in technical risks in nursing work, thus affecting nursing safety.
1.2 management.
1.2. 1 unreasonable staffing. The traditional scheduling mode can no longer meet the needs of constant change and development. The main problem exposed by the old dispatching mode is that it is not timely to run the red light during busy hours; Treatment and nursing are carried out in groups, and nurses do not know the patient's condition and progress; Nurses who work at night are under great pressure, especially psychological pressure.
1.2.2 the safety management system is not perfect, the feedback is not timely, the potential safety hazards are not found or summarized in time, similar errors or accidents occur repeatedly, nursing writing, disinfection and isolation, safety care for critically ill patients, unclassified basic nursing and continuous improvement, and nursing safety education is not perfect.
1.3 environmental aspects.
1.3. 1 ward environment. Most patients with chronic diseases in respiratory medicine have low immune function. Patients and their families are worried about catching a cold and are unwilling to open the window for ventilation. In addition, some patients urinate in bed and expectorate at will, which may cause odor indoors and the number of bacterial colonies in the air exceeds the standard, which increases the incidence of hospital infection and is not conducive to the physical and mental rehabilitation of patients.
1.3.2 safety protection. Patients who are restless and inconvenient to move do not use the protective fence in time, which is easy to cause bed fall; Falling, falling out of bed, inconspicuous signs of pressure sore, bedside pager not being placed in a place where patients can easily use it, water on the ground not being dried in time, obstacles in the passage, unstable seats, etc. may all cause patients to fall. He can't call for help in time when he falls or has an accident; When the bathroom lamp and floor lamp are not working properly, they are not maintained in time; The use of electrical appliances, such as mobile phone chargers, computers, rice cookers, etc. , interfere with the normal operation of medical instruments.
Nurse 1.4.
1.4. 1 did not strictly implement the three checks and eight pairs, especially when the patient was busy, the contents of the three checks and eight pairs could not be put into practical work, such as misreading and missing the doctor's advice when executing the doctor's advice, not asking for instructions, not reporting, giving the wrong medicine or not delivering the medicine on time. [2]
1.4.2 nurses have a poor sense of responsibility, neglect their duties, fail to perform their duties seriously, fail to implement various rules and regulations and nursing routines seriously, violate operating procedures, leave their posts without permission, make rounds in time, and observe their illness carelessly.
1.4.3 Lack of legal knowledge, weak awareness of self-rights, and neglect of learning and professional and technical training.
1.5 patients.
1.5. 1 patients know little about their own diseases. It is inconvenient for patients to stay in bed for a long time, and most of them are elderly patients, which are prone to complications such as urinary tract infection and pressure ulcers. Because of this, under the influence of factors such as increased complications, limited long-term activities, increased medical expenses, and patients' lack of understanding of diseases, it is easy to have resistance or distrust of nursing staff, leading to adverse consequences such as doctor-patient disputes [3].
1.5.2 Some patients with unknown symptoms often don't abide by and cooperate with hospital rules and regulations, leave the hospital without authorization or don't return on time after taking leave; Patients and their families have high expectations for medical treatment, and they don't understand and accept the deterioration of their condition.
2. Preventive measures
2. 1 technical aspects.
Formulate and improve the grading training plan, conduct regular professional technical theory training, and conduct regular operational skills assessment. Nurses should not only master the professional knowledge of various disciplines, but also have skilled rescue skills, good cooperation with colleagues and high stress ability. Therefore, managers should provide nurses with conditions for further study, constantly meet their needs for new business and new technical knowledge, and at the same time cultivate their interpersonal skills accordingly.
2.2 management.
2.2. 1 flexible scheduling. With few nurses, heavy tasks and overwork, most nurses can't adapt to the transformation of multiple roles, resulting in role conflict, which is harmful to nurses' physical and mental health and an important reason for unsafe factors in hospitals. Therefore, our department boldly reforms the scheduling mode, implements flexible scheduling, enriches the manpower allocation during busy hours, and implements flat management and group management in the day shift to implement holistic nursing for patients; Changing night shift to double shift system can obviously improve the current situation of nurses' overload work, and at the same time reduce the psychological pressure of night shift nurses.
2.2.2 Strengthen nursing safety education and improve risk prevention. Take safety and accident prevention education as a regular education work and firmly establish it? Safety first, safety first? The idea. [4] Our department holds 1 nursing safety meeting every month; Four core quality control team leaders were selected to be responsible for nursing writing, disinfection and isolation, safety nursing of critically ill patients and basic nursing. The core team leader conducts monthly investigation of nursing safety hazards, arranges records and puts forward rectification measures in time; Reward the reports of adverse events, and conduct case analysis and discussion on adverse events to avoid the recurrence of similar mistakes or accidents; Commend good practices and individuals in nursing safety management and correct existing problems in time.
2.3 Environmental aspects.
2.3. 1 instruct patients and their families to open windows for ventilation in time, and use negative ion sterilizers for disinfection regularly, so as to reduce indoor air bacteria and reduce the incidence of nosocomial infection.
2.3.2 For patients who are fidgeting and inconvenient to move, guardrails should be set on both sides in time; When there is a high risk of falling, falling out of bed and pressure sore, turn over the bedside high-risk sign; Inform patients about the use of pagers, and put the elderly who are unaccompanied and inconvenient to move where they can easily get them; Put anti-skid signs in the tea room and bathroom, and urge the health workers to mop up the water stains on the ground in time and remove obstacles in the passage in time; Check the seat regularly, and send it for repair in time if it is loose; Place anti-skid pads and handrails in the toilet; Check the running status of bathroom lamps and floor lamps regularly every month, and repair them in time if any abnormality is found; Check the electrical boards and sockets during rounds, and stop using other electrical appliances in time.
2.4 Nurse.
2.4. 1 Strictly implement the system of three checks and eight pairs. Three inspections: inspection during and after drug preparation, inspection before drug delivery, injection and disposal, inspection after drug delivery, injection and disposal; Eight pairs: bed number, name, drug name, dosage, concentration, time, usage and expiration date. Seriously understand the contents of three investigations and eight pairs, and strictly implement them. Three checks and eight pairs run through nursing work; When hanging medicine or changing medicine, two or more methods (such as bedside card, patient response, wristband, ID card, etc. ) to identify the patient's identity, which can only be implemented after it is accurate. Put an end to mistakes and accidents.
2.4.2 Strengthen nurses' sense of responsibility, talk to nurses who are often negligent in their work, strengthen the supervision of nurses to perform their respective duties, implement various rules and regulations and nursing routines, and emphasize that nurses must complete nursing work according to operating procedures, stick to their posts, patrol wards according to grading nursing system, observe their illness and avoid medical accidents.
2.4.3 Strengthen the study of legal knowledge and manage it according to law. In 20 12 years, all the nursing staff in our department earnestly studied the new regulations on handling medical accidents, the code of ethics for medical staff and its implementation methods, and learned lessons from typical cases, so as to keep the alarm bells ringing and make the nursing staff,
Scholars know, learn and understand the law in practice, restrain their behavior in their work and serve patients dutifully.
2.5 patients.
2.5. 1 Strengthen the nursing of complications and patients' psychology [3]. Patients need to stay in bed because of shortness of breath, and their daily activities are more or less restricted. Therefore, the incidence of urinary tract infections, pressure ulcers and other complications is high, and patients' emotions are also unstable. In addition to giving psychological care, we should also formulate strengthening measures to prevent it. Nurses should communicate with patients between work as much as possible, analyze their illness, correctly guide patients with anxiety and depression to vent, and stabilize their emotions as soon as possible.
2.5.2 Do a good job in hospitalization education. Patients should strictly abide by the rules and regulations of the hospital, and must not go out without permission or return on time after taking leave, otherwise they will be discharged automatically. The responsible nurse should be very familiar with the patient's condition and do a good job of explanation and notification.
summary
Nursing service industry is a high-tech and high-risk industry, and nursing risk runs through the whole nursing activity, which is objective and eternal. Therefore, we should keep in mind eight viewpoints of nursing safety culture: prevention first, safety first, safety first, safety is benefit, safety is quality, safety is productivity, risk minimization and scientific safety management [5]. Every nurse should take action, constantly absorb new knowledge, update ideas, find reasons from clinical work and management, constantly find problems, and formulate a series of corresponding measures to ensure the safe and smooth progress of medical work.
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