You must know the nature of drugs. What's wrong with the patient?
What are the hidden dangers of hospital fires?
Whether the facilities such as fire exits, fire stairs, fire elevators, emergency lighting, fire hydrant systems, evacuation indicators, safety indicators and automatic alarm systems are complete, perfect and working normally. It will become a safety hazard of hospital fire fighting.
What are the hidden dangers of clinical nursing?
With the continuous development of medical science and technology and the improvement of people's living standards, patients and their families are more and more familiar with the legitimate rights and interests of medical care, which puts forward higher requirements for medical quality, nursing quality and medical safety. The author has been engaged in clinical nursing and education for nearly 30 years, and knows that nursing safety is an important indicator to measure nursing service, and it is also one of the most direct and important indicators for patients to choose medical treatment. As a gynecological nurse, we should standardize feasible safety precautions at any time, strengthen management, provide quality services for patients and reduce the occurrence of unsafe nursing. The author analyzed the causes of common security risks in nursing and discussed the corresponding preventive countermeasures.
1 analysis of the causes of potential safety hazards in clinical nursing
The professional quality and sense of responsibility of 1 need to be improved.
The quality of nursing staff is the primary factor related to nursing safety. Lack of professional knowledge and work experience is a common safety hazard in nursing work in some primary hospitals. Some nursing staff have low technical level or unskilled skills, do not cooperate well with others, do not pay attention to learning and professional technical training, and violate technical operation procedures, which often leads to operational errors or operational errors and nursing defects and accidents, thus leading to nursing complaints. Many cases, such as patients falling out of bed, falling, scalding, suicide, etc. It is all caused by nurses' off-duty, sleeping at work, delaying or omitting treatment, not making rounds on time, not carrying out doctor's orders correctly, and not finding out the patient's condition in time, which are all manifestations of nurses' weak sense of responsibility.
2 poor service attitude, lack of legal awareness
Poor service attitude is also a major safety hazard, such as using service taboos at work, not paying attention to the way and tone of conversation, and simply answering questions, which leads to misunderstanding of patients. If nurses lack understanding of patients and their families, ignore service attitude and psychological needs of patients, they will not meet patients' expectations and requirements. Patients are not ordinary consumers. Paying for medical treatment in the hospital shows that the hospital has established a contractual relationship with patients and formed a medical service contract. Hospitals provide medical care services for patients through medical staff. The nurse's behavior is not only a personal behavior, but also represents the hospital to perform the contract, and has the obligation to provide quality services to patients and safeguard their rights and interests. When nurses can't realize this and there is a gap between the actual work and the patient's requirements, it will lead to complaints.
3 nursing facilities are not standardized and lack of investment
In the construction and renovation of hospital facilities, the managers of this grass-roots hospital did not fully consider the requirements of nursing work and the comfort needs of patients, resulting in unreasonable facilities and poor conditions. For example, stairs and toilets have no handrails, and the ground is slippery and bright. Some hospitals only pay attention to the investment of large-scale equipment and facilities that can produce direct economic benefits, but ignore the basic investment of nursing equipment, resulting in the shortage and deficiency of nursing equipment, thus forming factors that affect nursing safety. For example, trolleys and stretchers are outdated, beds have no railings, and rescue instruments are poorly maintained. In particular, some rescue instruments that are not often used at ordinary times are too small to be used in rescue.
4 quality management system is not standardized
Governance is to determine the functions and activities necessary to meet the quality requirements. Quality management system is the core of nursing safety management. Imperfect governance system and inadequate quality control are all important factors that cause nursing insecurity. Nursing management is the core of nursing safety. Only when the treatment is in place can the nursing safety of patients be guaranteed. Under normal circumstances, nurses lack scientific management methods, which are mainly manifested in imperfect system, rules to follow, lax organization and management, and lack of management, supervision, inspection and guidance step by step. For example, there are drugs and articles in the rescue vehicle, which are placed in disorder, the location is not fixed, the rescue drugs are not counted, the labels are unknown, and the rescue instruments are not on standby.
2 safety concepts and countermeasures
1 Enhance the legal awareness of nursing staff
Strengthening the legal knowledge education of clinical nurses is an effective means to prevent nurse-patient disputes and reduce nursing insecurity. Through irregular legal lectures, combined with actual case analysis, nurses can understand the legal knowledge related to medical work, further analyze what is tort in clinical nursing work, make clear that nursing work is closely related to law, and safeguard the rights and interests of both nurses and patients according to law. For example, the Law on the Prevention and Control of Infectious Diseases and the General Principles of Civil Law clearly regulate and restrict nursing behavior. Nurses must be clear about the legal provisions and obligations related to nursing work, improve their awareness of self-protection, engage in nursing services according to law, correctly perform their duties and prevent disputes between nurses and patients. Let nurses be familiar with the adverse legal consequences caused by their illegal actions, strengthen their sense of responsibility, and let nurses know what they should do and how to do it, so as to safeguard patients and themselves ... >>
Rectification measures for nursing safety problems
A, nursing hidden dangers and their causes
1, potential nurse-patient dispute
Clinical nurses are young, lack of experience and technology, unable to hit the nail on the head, with a large amount of liquid, few personnel, untimely liquid replacement, easy to return blood and block the infusion tube, and unable to insert the needle in time after pulling out the needle. A series of factors have led to a sharp increase in the views of patients' families on nurses. Once the patient's condition deteriorates, it will directly lead to disputes.
2. Basic nursing is not in place.
Because nurses are busy adding medicine and changing fluids, they have no time to take care of the basic nursing contents of patients, such as turning over, patting the back, nasal feeding, high fever, diabetes insipidus and constipation. , to the family operation. If there is any abnormality, the nurse will be told to report it to the doctor for treatment, which can not guarantee the timely observation of the condition, and it is easy to cause complications or miss the best treatment opportunity. It's not that I don't do it, but that I don't have time. Feeling that nursing work is only quantity, not quality. I've been very busy, and I really haven't done much for the patients. Especially when on duty on weekends, many doctor's orders can't be carried out on time, so they can only wait until after work. In short, under the limited human resources, there is no scientific and overall management and distribution method to make the nursing work perfect.
3. There are many security risks.
Take a few bottles at a time when changing the liquid, and accidentally change the wrong bed number; The infusion card is unclear,
It's not convenient to check. First, it affects the speed of checking. Second, it is easy to correct the wrong medicine. Frequent bed shifting and error-prone operation; Most of the night shifts and shifts are young nurses, who lack work experience and communication skills, and can't detect the changes of patients' condition in time, which affects the rescue treatment; Critical and surgical patients are placed in general wards, with a long journey and few staff, which brings inconvenience to observation and treatment, increases workload and difficulty of work, and there are different degrees and different nature of safety hazards in each class, so medical care safety is facing great challenges.
4. Nurses have serious physical exhaustion and high mental tension.
Because of the heavy workload, fear of making mistakes and strong sense of responsibility, nurses are in a state of high mental tension, psychological pressure and serious physical overdraft, which is not conducive to physical and mental health in the long run. Loss of enthusiasm and enthusiasm for work, lack of love and sympathy for patients, lack of attractiveness of departments and lack of cohesion of teams are not conducive to the stability and professional development of nursing teams.
5. There are many problems and difficulties in escort management.
There are many critically ill, surgical and coma patients, and the number of nurses is small. They are tired of completing basic treatment every day and have no energy and manpower to provide basic life care. So you can't limit the number of people accompanying you. When the escort stays in the department, the consumption of water, electricity, heating and ward facilities is large, and the escort smokes at night, sleeps on the floor, chats, and the aisle is full of clothes. They are repeatedly banned, and there are many opportunities for friction with medical care, which increases the possibility of cross-infection and many security risks. It is not ideal to limit the number of accompanying staff from the ward alone.
Second, preventive measures.
1, strengthening safety quality education, improving nursing safety awareness and eliminating unsafe hidden dangers in nursing work are the guarantee to avoid risks.
(1) Newly recruited nurses must study the Regulations on Handling Medical Accidents and pass the examination before entering clinical work. Rotation nurses must enter our intensive care unit for more than 3 months before they can follow the teacher. During this period, operation training and theoretical strengthening were carried out. And teach the basic skills of communicating with patients and their families, and have the basic ability to deal with disputes.
(2) Regularly organize nursing staff to carry out legal education, use safety cases to reason, analyze illegal cases to sound the alarm, firmly establish the concept of "safety first, quality first", enhance the awareness of laws and regulations, and enhance the understanding of the consequences of unsafe factors in nursing.
(3) The nursing department conducts nursing quality evaluation meeting and safety education at the general meeting of nurses in the whole hospital every quarter, and comments on the work situation at the regular meeting of the head nurse every month, including those existing in the work.
The unsafe hidden dangers, nursing errors and defects, and major accidents should be analyzed and informed criticism.
(4) The head nurse uses the morning shift every day to remind and prevent the problems that are easy to appear in the nursing work of the department.
2. Adjusting shifts and refining work flow and work system are reliable guarantees to reduce nursing risks.
Strengthen the staffing during the weak nursing period, such as increasing staff at noon and weekends, matching the old and the young, etc., improve work efficiency, timely observe the illness and deal with emergencies, and eliminate disputes in the bud. Adjust the original all-night shift to double shift day and night, and keep the helper class, which will reduce the pressure of increasing personnel and make the work enjoyable. Strengthen the staffing of intensive care unit, refine the post responsibilities of each shift, clarify the duty responsibilities, do a good job in nursing critically ill patients, implement basic nursing responsibilities, and ensure nursing safety.
3. Strengthen communication with patients, master communication skills, improve service attitude, standardize service behavior, and protect patients' privacy. This is an effective measure to reduce nursing disputes ... >>
What are the aspects of nursing safety education?
Nursing safety education
First, strengthen nursing safety education, establish a patient-centered service concept, and vigorously advocate the concept of changing passive service into active service. Specific measures:
1. Nurses must adhere to the system of weekly meeting, participate in weekly medical safety education and study, and be punished according to hospital rules and regulations once.
2. Combining with the "Demonstration Project of Quality Nursing Service" carried out in our hospital, we should establish a patient-centered service concept, take the initiative to serve, strengthen the sense of responsibility of nursing staff, advocate the "love, carefulness, patience and responsibility" of nursing staff to serve patients, and carry out the selection activities of advanced individuals for quality nursing service.
3. By strengthening clinical nursing work and consolidating basic nursing services, we will establish a good image of the medical and health industry serving the people wholeheartedly in the whole society, carry forward the humanitarian spirit of saving lives and promoting the harmonious relationship between doctors and patients.
Two. Establish and improve relevant rules and regulations, and clarify job responsibilities. Summarize experience, gradually explore and improve the hospital nursing management system suitable for our hospital, establish a long-term mechanism for continuous improvement of nursing quality, and continuously improve the level of nursing work.
Specific measures:
1. It is necessary to further implement the requirements of Nurses Regulations, Notice of the Ministry of Health on Strengthening Clinical Nursing in Hospitals, Guiding Principles of Graded Nursing in General Hospitals (for Trial Implementation), Basic Nursing Service for Inpatients (for Trial Implementation), Work Standard of Basic Nursing Service and Technical Service Standard of General Clinical Nursing, effectively strengthen nursing management, standardize nursing service and consolidate basic nursing.
2. Establish and improve relevant rules and regulations, and clarify job responsibilities.
1) Hospitals and wards have complete creation plans, objectives, tasks and implementation measures, and nursing staff are registered and standardized in practice.
2) Establish and improve clinical nursing rules and regulations, disease nursing routine and clinical nursing service norms and standards.
3) Establish the post responsibility system for nurses, formulate and implement the post responsibilities and work standards of nurses at all levels, and standardize clinical nursing practice.
4) Establish a performance appraisal system for nurses, and combine the assessment results with the promotion assessment of nurses according to the quantity and quality of clinical nursing work completed by nurses and the satisfaction of inpatients.
3. Clarify the basic nursing items and work norms that clinical nurses should be responsible for, and must perform basic nursing duties, standardize nursing behaviors and improve nursing services.
4. Clarify the connotation, service items and working standards of clinical nursing service. The service connotation and service items of graded nursing should include patient's condition observation, treatment and nursing measures, life nursing, rehabilitation and health guidance. And bring it into the hospital affairs disclosure, and introduce the evaluation mechanism of patients and society as the content to be disclosed to patients.
3. Strengthen the study of laws, regulations, rules and regulations and work norms.
Specific measures:
1. At least once a month, we should study the laws and regulations such as Nurses' Regulations, Notice of the Ministry of Health on Strengthening Clinical Nursing in Hospitals, Guiding Principles of Graded Nursing in General Hospitals (Trial), Basic Nursing Service for Inpatients (Trial), Basic Nursing Service and Common Clinical Nursing Technical Service, so that nurses can master various rules and regulations and laws and regulations.
2. Establish and improve various rules and regulations, strictly implement operating procedures, constantly standardize nursing workflow, and formulate patient safety management plans. 3. Strengthen the management of quality monitoring measures, intensify key quality control, establish departmental quality control teams, and regularly check the implementation and quality management of each link, so as to nip quality problems in the bud and eliminate and reduce hidden dangers.
4. Repeatedly strengthen nurses' legal awareness, use morning meetings and peacetime business study to teach legal knowledge and cases to prevent medical disputes, and tell nurses with specific cases that any negligence in a small link may cause irreparable losses. Hold regular safety analysis meetings, so that nurses can find the links that are prone to errors, especially the existing problems, analyze the reasons and formulate improvement measures. Update the management concept, encourage nursing staff to report potential safety hazards, and set up a reward system for self-inspection and reporting potential hazards. If they conceal it, they will be punished according to the corresponding system.
4. Strengthen the study and assessment of "three basics" and "three strictness" in nursing,
Specific measures:
1. There is a theoretical examination and a technical operation assessment every time.
2. Encourage nursing staff to participate in various forms of business learning and training inside and outside the hospital.
3. Formulate preferential policies to encourage nursing staff to participate in adult higher education and improve their professional skills and theoretical knowledge.
Please come in and go out to strengthen the study of new nursing business and technology once every two days ... >>
There are several common ways to make beds in wards.
(1) spare bed: keep the ward clean and accept new patients at any time.
⑵ Temporary empty bed: keep the ward clean and tidy for new patients or patients who get out of bed temporarily.
⑶ Anesthesia bed: It is convenient for postoperative nursing, making patients safe and comfortable, preventing complications, avoiding bed pollution and easy to replace.
(4) Bedridden patients change sheets: keep patients clean, make patients feel comfortable, and prevent complications such as pressure ulcers.
What are the hazards of production safety accidents in crowded places?
First, the hazards of production safety accidents in crowded places:
(1) Fire accidents;
(2) explosion accident;
③ Poisoning accident;
(4) drowning accident;
⑤ Equipment and facilities accident: refers to the accident caused by equipment and facilities failure;
⑥ Public security accident: refers to accidents caused by public security incidents;
⑦ Scalding accident: refers to an accident that local or large-area injuries are caused by high temperature caused by man-made or unexpected reasons;
(8) Collapse and collapse accident: refers to the accident of ground collapse and house collapse caused by geological, weather or man-made reasons;
Pet-name ruby leakage accident: refers to the accident that gas seeps into the air or liquid flows into the open air due to the tanker or oil-gas pipeline filled with oil, gas and toxic substances for some reason;
⑩ Scraping accident: refers to the scraping collision accident of public transport for some reason;
Accident: refers to accidents such as burns and strain caused by human factors;
Other accidents: including falls, car accidents, electric shock, collision, infringement and other unclassified accidents or events.
Second, according to the Ministry of Public Security Decree No.73 "Regulations on Fire Supervision and Inspection" (implemented on September 1 2004), Article 35 has stipulated that:
The crowded places mentioned in these Provisions refer to the following places:
1, hotels, restaurants, shopping malls, bazaars, stadiums, auditoriums, public places of entertainment and other public gathering places;
2. Outpatient and ward buildings of hospitals, teaching buildings, libraries and dormitories of schools, nursing homes, nurseries and kindergartens;
3. Waiting halls (buildings) for passenger stations, docks, civil airports, boats, etc.
4. Reading rooms of public libraries and exhibition halls of public exhibition halls;
5. Production and processing workshops and dormitories of labor-intensive enterprises.
Third, the characteristics of crowded places
1, with large population and high density. Crowded places tend to have a high concentration of people and accept many people at the same time in a certain space. On-site safety management is difficult, and most people lack common sense of escape. In the event of a fire accident, it is difficult for people to evacuate and escape, which can easily lead to mass deaths and injuries.
2. The mobility of personnel is high and the composition of personnel is complex. Due to individual differences, in the face of unexpected situations, it is easy to cause chaos at the scene, which in turn leads to accidents.
3. The use nature of the building where the place is located has changed. Independent buildings are rarely used in crowded places such as bars, Internet cafes and restaurants. Operators usually rent a part of a building for renovation, some in a certain floor of a shopping mall or office building, some in abandoned warehouses or factories, some in the first floor of a residential building, and some even carry out renovation in a residential building.
What is the duty of the head nurse in the ward?
The duties of the head nurse in the ward are: 1. Organize and lead the professional study and technical training of nursing staff. Second, responsible for the management of the ward, including the scheduling, rotation and temporary deployment of nursing staff, the clean, safe and quiet environment of the ward, the management of patients, caregivers and visitors, and the management of various instruments, equipment and medicines. Three, responsible for the management and guidance of internship, trainee, and specify the excellent nursing staff to teach. Fourth, urge the staff, hygienists and caterers of this group to do a good job in various disinfection and isolation systems and cleaning and hygiene work. Fifth, hold regular work and rest forums to listen to opinions on medical care, nursing, diet and hygiene, and study and improve ward management. Six, under the leadership of the head nurse and the business guidance of the director, according to the work plan of the nursing department and the department, formulate specific plans for this ward and organize their implementation. Seven, responsible for checking and understanding the nursing work in the ward, participating in and guiding the nursing and rescuing patients in critical and major operations, urging nursing staff to strictly implement various rules and regulations and technical operating procedures, checking the implementation of doctor's orders in a planned way, strengthening medical cooperation, and preventing mistakes and accidents. Eighth, attend the morning shift and bedside shift, accompany the director to make rounds, understand the problems existing in nursing work, and strengthen medical contact. Participate in the consultation and discussion of major surgery, new preoperative, difficult cases and deaths in the department. Ninth, be responsible for the political and ideological work of nurses in this ward, educate nurses to enhance their sense of responsibility, improve their service attitude and abide by labor discipline. Tenth, organize nursing rounds and consultations in this ward, actively carry out new technologies, new services and nursing research, and personally participate in the practice of complex nursing technologies and new nursing services.