First, the principle of graded nursing
(a) to determine the level of care of patients, it should be based on the patient's condition and self-care ability, and dynamically adjust according to the changes in the patient's situation.
(two) patients in any of the following circumstances can be identified as entitled groups:
1, critically ill patients whose condition may change at any time and need to be rescued;
2. Intensive care patients;
3. Patients after various complicated or major operations;
4. Patients with severe trauma or extensive burns;
5. Patients who use a ventilator to assist breathing and need close monitoring;
6. Implement continuous renal replacement therapy (CRRT) and closely monitor the vital signs of patients;
7. Other life-threatening patients who need to closely monitor vital signs.
(three) patients with one of the following circumstances can be identified as first-class care:
1, critically ill patients whose condition tends to be stable;
2. Patients who need to stay in bed strictly after surgery or during treatment;
3. Patients whose life is completely unable to take care of themselves and their condition is unstable;
The patient takes care of himself, and his condition may change at any time.
(four) patients with one of the following circumstances can be identified as secondary health care:
1, patients whose condition is stable and still need to stay in bed;
2. Take care of your patients.
(five) patients with one of the following circumstances can be identified as tertiary care:
1, the patient is completely self-care and the condition is stable;
2. Patients who take care of themselves completely and are in recovery period.
Second, the main points of graded nursing
(a) nurses should abide by the clinical nursing technical specifications and disease care routine, and carry out nursing work according to the nursing level of patients and the diagnosis and treatment plan formulated by doctors.
The nursing work carried out by nurses includes:
1, closely observe the patient's vital signs and condition changes;
2, the correct implementation of treatment, medication and nursing measures, and observe and understand the patient's reaction;
3, according to the patient's condition and self-care ability to provide care and help;
4. Provide health guidance related to nursing.
(2) The care of intensive care patients includes the following points:
1, closely observe the changes of patients' condition and monitor vital signs;
2, according to the doctor's advice, the correct implementation of treatment and administration measures;
3, according to the doctor's advice, accurately measure the discrepancy;
4, according to the patient's condition, the correct implementation of basic nursing and specialist care, such as oral care, pressure sore care, airway care and pipeline care. , implement safety measures;
5. Maintain the patient's comfortable functional posture;
6, the implementation of bedside succession.
(3) The care of primary care patients includes the following points:
1, patrol patients every hour to observe the changes of patients' condition;
2, according to the patient's condition, measuring vital signs;
3, according to the doctor's advice, the correct implementation of treatment and administration measures;
4, according to the patient's condition, the correct implementation of basic nursing and specialist care, such as oral care, pressure sore care, airway care and pipeline care. , implement safety measures;
5. Provide health guidance related to nursing.
(4) The care of secondary nursing patients includes the following points:
1, patrol patients every 2 hours to observe the changes of patients' condition;
2, according to the patient's condition, measuring vital signs;
3, according to the doctor's advice, the correct implementation of treatment and administration measures;
4, according to the patient's condition, the correct implementation of nursing measures and safety measures;
5. Provide health guidance related to nursing.
(5) The care of patients with tertiary care includes the following points:
1, patrol patients every 3 hours to observe the changes of patients' condition;
2, according to the patient's condition, measuring vital signs;
3, according to the doctor's advice, the correct implementation of treatment and administration measures;
4. Provide health guidance related to nursing.
(6) Nurses should care about and care for patients at work, and communicate with doctors in time when they find that patients' condition changes.
Third, quality management.
(a) the hospital should establish and improve the nursing rules and regulations, nurses' job responsibilities and codes of conduct, strictly abide by the implementation of nursing technical operation norms and disease care routines, and ensure the quality of nursing services.
(two) the hospital should promptly investigate and understand the opinions and suggestions of patients and their families on nursing work, analyze and deal with them in time, and continuously improve nursing work.
(3) Hospitals should strengthen the reporting of nursing adverse events, investigate and analyze them in time, prevent the occurrence of adverse events and promote the continuous improvement of nursing quality.