Summary report on continuing education in hospital 1
The main direction of my further study is the conservative treatment of "neck, shoulder, back and leg pain" and the surgical treatment of "limb fracture". The further education departments are neck, shoulder, lumbocrural pain, upper limb injury and hand surgery. The treatment center for neck, shoulder, back and leg pain consists of four departments, with a total of 170 beds. It is the largest TCM treatment department for cervical and lumbar spondylosis in China. The department of upper limb injury and hand surgery are the departments for surgical treatment of limb fractures and vascular and nerve injuries.
I. Further study:
Go to the hospital for rounds at 7: 00 every morning, check the patient's treatment, ask the patient's feelings, and solicit the patient's opinions on treatment, focusing on the newly admitted patients and patients after surgery (or volume reduction). Answer the patient's questions and doubts, report the problems that you can't solve to the teacher in time, ask the teacher for advice, solve them with the teacher, and complete the patient's treatment (such as dressing change and doctor's advice, etc.) in time. ).
During my study in the department of neck, shoulder, back and leg pain, I mastered a set of effective non-surgical treatments for neck, shoulder, back and leg pain, namely Luoyang osteopathy.
Excellent traction method: the bedside multifunctional traction frame is adopted, and the corresponding traction angle, traction weight and traction time are adopted according to the different conditions of patients, so as to achieve the therapeutic effect of bone setting and tendon adjustment.
Traditional Chinese medicine treatment: Pingle bonesetting divides this disease into three types: one is qi stagnation and blood stasis, the other is cold and dampness stagnation, and the third is liver and kidney deficiency. Luoyang Orthopedic Hospital adopts self-developed Jingtongxiao Pill, Intervertebral Disc Pill and Zhongqishushu Pill, which are treated by stages according to the three types, and adopts traditional Chinese medicine fumigation, iontophoresis and other traditional Chinese medicines for external use to warm meridians and dispel cold and dredge meridians, so that external treatment can play the role of internal treatment.
Massage with Jin Zhandan: According to the principle of acupuncture that "acupoints are wide open but not smothered, causing evil spirits to fly", combined with the specific situation of neck, shoulder, waist and leg pain, select corresponding acupoints or reaction points, sprinkle Jin Zhandan (powder) on them, and use specific massage techniques to make drugs and techniques work together, which has the functions of promoting blood circulation, relieving pain and dredging meridians.
Manipulation therapy: divided into tendon manipulation and bone manipulation. The main methods of tendon treatment are rational tendon, flexible tendon and relaxed tendon. Bone-setting manipulation is mainly a variety of joint movements, including lifting estimation, three-dimensional traction bed fixed-point rotation and so on. This manipulation can effectively adjust the position of spinal intervertebral disc and facet joints, and change the anatomical relationship between protrusion or osteophyte and stimulated nerve roots or spinal cord and blood vessels (that is, displacement theory), thus reducing the tension of nerve roots or the stimulation of osteophyte to nerves and blood vessels, and achieving the purpose of bone healing and pain relief. The manipulation of tendon therapy is closely combined with the manipulation of bone therapy, and the dynamic muscles around the spine are relaxed by means of activating tendons, adjusting tendons and loosening tendons, such as clicking, pressing, pushing and kneading, so as to achieve the effect of relaxing tendons and relieving pain.
Ozone injection therapy and sacral canal therapy.
Functional exercise: According to patients' different physical endowments and specific conditions, formulate corresponding personalized functional exercise programs, and selectively apply functional exercise methods of neck, waist, back muscles and dynamic muscle groups around the spine, such as neck-arm struggle, flying geese, walking backwards, arch bridge exercise, etc.
During my study in the operating department, I went to the hospital for ward rounds in advance to complete the patient's treatment in time. Go to the operating room around 8: 30 to visit or participate in the operation. As an assistant or two assistants, Luoyang Orthopedic Hospital has to perform more than 60 operations every day on average. The operating room has 14 ordinary operating room and 1 emergency operating room. The huge amount of surgery is a great challenge to the operating room, so the arrangement of the next operation is generally very compact, and the operating room has a corresponding "operation preparation room". Almost half an hour before an operation, the visiting nurse will inform the next operation, and the patient will be monitored and resuscitated in the "anesthesia recovery room" after the operation. The interval between two operations is about 10 minute. There is a lounge in the operating room where doctors and nurses can rest and eat. The whole operating room can't get off work until 2 1: 00 on average (except emergency), and write medical records and read books to solve their own problems at night. In addition, I actively participated in the preoperative case discussion of orthopedics, and discussed all operations the next day.
During the study and further study, I will abide by the rules and regulations of hospitals and departments, respect teachers, unite colleagues, and be strict with myself, so as not to be late, leave early, be absent from work without reason, or leave my post without permission. He is affable to patients, has a good attitude, and tries his best to put the theoretical knowledge and basic skills he has learned into practice, which has been highly praised by department directors, teachers and patients. In this process, I constantly sum up my learning methods and clinical experience, strive to improve my ability to think independently, solve problems independently and work independently, and constantly cultivate my lofty thoughts and good professional ethics of serving the people wholeheartedly. Through this study, I improved my level of writing related medical literature. Enhance the ability of diagnosis and treatment of common and frequently-occurring diseases in orthopedics; Further mastered the conservative treatment. In the meantime, I also actively participated in "How to write a good medical paper", "Seminar on New Progress of Limb Tissue Defect" and "National Hip and Knee Joint Disease Summit Forum in" sponsored by Luoyang Orthopedic Hospital, as well as other business studies organized by various departments, and had academic exchanges with experts. Through study and communication, I have greatly broadened my horizons, enriched my knowledge and learned some new surgical methods and techniques.
Second, the feeling of further study
1, good doctor-patient communication
We attach great importance to doctor-patient communication and have good habit of doctor-patient dialogue, which is worth learning. Knock on the door before entering the ward, ask about the illness, do physical examination, explain the diagnosis and treatment matters, listen to the complaints and demands of patients very patiently, and the doctor-patient relationship is very harmonious.
2, standardize the diagnosis and treatment behavior
Medical activities are very standardized, and medical activities are carried out according to the unified "jci standard". For the choice of treatment methods: surgery or conservative treatment, as well as their advantages and disadvantages, doctors will also discuss the choice of internal fixation devices with patients and their families, and they will decide the plan, thus showing respect for patients and ensuring their right to informed consent.
3. Protect patient privacy and information confidentiality.
There is no list of inpatients in each department, and doctors should exit the patient interface when they leave the computer; During the treatment operation, the bed curtain should be pulled; Can't talk about illness or patient information in public places; Can't talk about the illness with people who have nothing to do with the patient treatment team; Members of the treatment group are not allowed to exchange illness or opinions loudly in the ward. Respect patients and protect their privacy.
4, to ensure patient safety:
Accurately identify patients.
After admission, the medical staff carefully checked the patient's identity, and put a wristband on each patient's wrist with a label indicating the patient's basic information to confirm his identity.
Improve the use safety of high-risk drugs.
The goal of patient safety first requires hospitals to make a list of high-warning drugs according to their own data and the requirements/guidelines of regulatory/industry organizations. Policies/regulations should emphasize the identification, location, labeling and storage of each high alert drug in the list. According to the actual situation, penicillin and cephalosporin for intravenous use are temporarily listed as high-risk drugs under specific conditions, and the potential risk of anaphylactic shock under special conditions is minimized through careful evaluation of each patient.
Reduce the incidence of nosocomial infection.
An important way to eliminate or reduce the risk of infection is hand hygiene. Every ward has a disposable disinfectant. Wash your hands before and after the evaluation, diagnosis and treatment of patients, and don't forget the importance of repeatedly educating patients and their families to wash their hands.
Reduce the risk of injury caused by patients falling/falling off the bed.
Evaluate patients, arrange high-risk and severe patients in bunks close to medical staff, strengthen education, including the education of accompanying personnel, and mark the bunks with sticky paper to prevent falling/falling off the bed.
Ensure that the surgical site is correct, the operation is correct and the patient is correct.
Wrong surgical site, wrong surgical operation and wrong patient operation are considered unforgivable, but such mistakes are common all over the world and have been the most reported warning events in the Joint Committee warning event database. Therefore, the goal of patient safety requires the hospital to formulate and implement the following measures: (1) marking the surgical site, which is obvious and easy to understand and difficult to remove or clean; Patients should participate in the validation process. When a patient enters the operating room, the hospital uses a checklist to confirm the correct patient, correct operation and surgical site marking. Relevant documents (such as preoperative evaluation and surgical plan, preoperative evaluation and informed consent), images and test results are ready, and all equipment/transplant instruments are confirmed to be in place, correct and effective. Before the official start of the operation, the whole operation team should stop all the operations at hand and verify again whether the operation site is correct, the operation method is correct and the patient is correct. This "pause" process should be recorded in the medical record.
Educate patients to use the alarm device in the bathroom.
Tell the inspector that there is an alarm in the patient's bathroom. If there is no escort, the patient's bathroom has problems, you can use the alarm device to inform the nurse and pay attention to the bathroom when patrolling the ward.
In the days of studying in _ _ _ _ _ hospital, I feel that the work here is very formal and orderly, all operations and all processes have standardized documents, and everyone in the ward works in an orderly way. Everyone's work enthusiasm and initiative are very high, and the relaxed and harmonious environment gives everyone a relaxed and healthy mentality. Everyone consciously abides by discipline, and the employees here are highly conscious and work in an orderly way. Everything is to "reduce risks and ensure medical quality and patient safety".
Three. Comments and suggestions:
The main purpose of learning is to apply what you have learned, use the advanced technology, advanced management mode and advanced ideas you have learned, and combine the actual situation of your unit to improve your work and improve the level of diagnosis and treatment. According to the present situation of the hospital, combined with what I have learned, I put forward the following opinions and suggestions.
1, develop new technology projects.
It is planned to carry out cervical and lumbar superior traction, Jin Zhandan massage, ozone injection therapy and sacral canal injection therapy, and gradually carry out cervical spine lifting and lumbar three-dimensional traction reduction treatment.
2, set up a department to treat neck, shoulder, back and leg pain.
With the increase of people's work pressure, increasing attention to health and the establishment of medical insurance system, neck, shoulder, back and leg pain has a wide range of sources and more patients. In order to make the treatment more systematic, standardized, make better results, really become bigger and stronger, and improve the competitiveness of the hospital. Clinics and departments for neck, shoulder, lumbocrural pain can be gradually established.
3. Reduce risks and ensure medical quality and patient safety.
_ _ _ _ _ _ 65438+February, _ _ _ _ _ _ Hospital passed the "jci Standard" certification. Jci standards mainly focus on the medical quality and patient safety of hospitals and their continuous improvement and improvement. It is the highest level hospital gold medal certification in the world. Jci certification process is a process of improving hospital quality and service. It is the process of implementing the service concept of "patient-centered" and strengthening the safe treatment of patients; We can learn some experiences from it: hospital system construction, continuous improvement of medical process quality, medical safety and so on. Thereby "reducing risks and ensuring medical quality and patient safety".
Studying in _ _ _ _ _ orthopedic hospital for half a year is a very valuable experience in my life, which has benefited a lot. Thank you for your care, support and help as always.
Summary report of continuing education in hospital II
June 65438+February 1, 20 _ _ _ _ to August 3 1, 20____ _ _ to the B-ultrasound room and ultrasound imaging department of the hospital for further study. Thanks to the director and hospital leaders for giving me this precious learning opportunity. During these nine months of further study, I have learned a lot about abdominal ultrasound diagnosis and ultrasound imaging. Have a deeper understanding of difficult cases; Have a clearer understanding of transvaginal three-dimensional ultrasound, ultrasound participation and contrast-enhanced ultrasound, and control standardized operating procedures and diagnostic points. Nine months of advanced study has greatly improved my professional level. During my further study, I studied the clinical work experience of the department in Union Medical College Hospital and shared the difficult cases I saw.
When I was studying abroad, I positioned myself, set my own learning bias, and made clear what I was studying, what new skills and knowledge I could bring after I stopped studying, and whether it could be reasonably widely used in Yangtze Hospital. Further study is not only to learn the punishment and treatment of common and frequently-occurring diseases in this major, but also to improve the diagnosis and treatment ability of complex and difficult diseases in this major-new skills and new treatments; During my further study, I always maintained excellent quality, actively learned new skills and worked hard to learn business knowledge. The works given by the advanced teachers are smiling, careful operation, strict declaration and being responsible for themselves, which have been well received by the advanced teachers.
On September, 20 _ _ _ _ _/day, I stopped studying and returned to work in the functional department of Changjiang Hospital. I actively feedback the new skills and knowledge I have learned to department leaders, colleagues and clinicians in the hospital, pass on the clinical application and diagnosis tips of new ultrasonic skills and new projects, and teach in the hospital. Organize obstetricians and gynecologists to discuss the application of transvaginal three-dimensional diagnosis in gynecological diseases, and invite obstetricians and gynecologists to attend classes in our department; Actively teach new skills, operating tips, diagnostic points and standardized writing of application forms to other colleagues in the department; At present, transvaginal three-dimensional ultrasound has been widely used in clinic, which provides better diagnostic support for clinic and has been confirmed by patients and obstetricians.
After coming back from further study, I not only brought new skills and new projects to the department; It also draws lessons from the department management methods of ultrasound imaging department of Union Medical College Hospital. Director Jin Tong further improved the work of functional departments of Changjiang Hospital, and arranged and printed it into a book, which was approved by the superior.
Over the past year, I have tried my best to do some work, but there are still some shortcomings. It is necessary to redouble solid and meticulous work measures, better combine principle with mobility, and improve the quality of work. At work, I always think that my professional knowledge and theoretical level need to be further improved because of the lack of talent and knowledge. Treat patients more carefully, patiently and enthusiastically.
Use culture to unite people's hearts and use the system to control life; In the new year, I will redouble my efforts to implement various rules and regulations, improve my professional level, and adhere to the principle of "saving lives and making friends"; Do a good job in the diagnosis and treatment of a patient and establish a reputation, and make greater contributions to the growth and support of the functional departments of Changjiang Hospital!
Summary report of continuing education in hospital 3
Three months of study and life ended in a blink of an eye. I gained a lot and felt that time passed very quickly. The harvest during this period has benefited me a lot and benefited me for life. After coming to Tianjin People's Hospital, I entered the endoscopy center to learn ERCP and its related diagnosis and treatment techniques. During this period, I strictly abide by the rules and regulations of hospitals and departments, respect teachers, unite colleagues, be strict in self-discipline, and care about patients' demands and pains. Strive to combine theoretical knowledge with practical experience, constantly sum up learning methods and clinical experience, and cultivate their ability to think and solve problems independently. The following are my most profound and rewarding experiences during my further study:
First, the humanized management mode:
Under the leadership of director Wen Li, all the medical staff in the endoscopy center are a good team. The relationship between colleagues is harmonious, and even the new refresher doctors feel warm when they join the team. Director Li often said that doctors should not treat themselves as outsiders, but we should treat you as our own. Newcomers are often reminded of details, such as the concept of sterility and radiation protection. Therefore, during the operation, the surgeon, assistant, surgical nurse, anesthesiologist, imaging doctor and refresher doctor perform their respective duties and assist each other. From preoperative preparation to postoperative anesthesia recovery, the most important operation quality and patient safety are ensured.
Second, advanced equipment and high-level technical level:
The ERCP operating room in the endoscopic center is well equipped and very reasonable. Endoscope, various monitoring equipment, aspirator and oxygen supply equipment are placed reasonably, and the accessories such as catheter, guide wire, incision knife, stone removal basket, stone crusher, stone removal balloon, nasal bile duct, bracket and biopsy forceps are fully configured and placed in a fixed position, which is convenient to use. In addition, what's more important is that the surgical team led by Director Wen Li is skilled, and can perfectly handle cases of unexplained obstructive jaundice suspected of extrahepatic biliary obstruction, stones, tumors, sclerosing cholangitis and other biliary diseases, suspected congenital biliary abnormalities or recurrence of symptoms after gallbladder surgery, and pancreatic diseases such as pancreatic tumors, chronic pancreatitis and pancreatic cysts, especially to prevent postoperative complications.
Third, rigorous work style:
For new senior doctors, teachers should teach, understand the environment of endoscopy center and the storage places of various items, master the use and precautions of various instruments, communicate with patients, strictly observe the concept of sterility, and improve the technical level of junior doctors through surgical demonstrations and lectures.
After three months of further study, I have mastered the intubation technology and precautions of ERCP, and I am familiar with the indications and contraindications related to ERCP and the treatment of postoperative complications. The task of further study was completed well, and no medical mistakes and medical accidents occurred. After further study, I will continue to study hard and put what I have learned into the work of serving patients wholeheartedly.
Summary report of continuing education in hospital 4
I feel very lucky to come to _ _ _ _ hospital to study neonatal intensive care. At first, I was a stranger. Because this learning opportunity is very rare, it took the hospital more than half a year to get it. So before coming, I think I must seriously study their advanced nursing concepts and techniques, and make this trip to glad you came. But after coming to Hong Kong, I found that apart from studying, the most important thing is to experience the cultural differences between Hong Kong and the mainland.
First, humanized management, first of all, good teamwork and diversified nursing staff echelon. The nursing team in each ward is equipped with ward manager, head nurse, specialist nurse and clinical nurse. Everyone cooperates with each other while completing their own work to ensure the nursing quality of the ward. In addition, they also have an organic section chief who is responsible for the daily management, debugging, maintenance and repair of instruments and the purchase of spare parts. Health service assistant, responsible for the replacement, replenishment and storage of nursing supplies; Ward assistant, responsible for terminal disposal and going out to do chores; Medical secretary, responsible for the reception, internal and external communication, statistics, sorting and storage of medical documents; Hygienist, responsible for ward hygiene (spotless effect required). Through the careful arrangement of personnel, everyone performs their duties, so that patients have a sense of security after admission, and everything is under the care of medical staff.
Second, the advanced technical level of equipment, excellent service and scientific and effective equipment setting are obvious features of Queen Mary Hospital.
Third, strict work style, in order to prevent accidents, the hospital stipulates that the dose of medical treatment must be checked by the pharmacy, and the dose can only be used on patients after being checked by two nurses; Special treatments, such as blood transfusion and application of curosurf, must be examined by both doctors and nurses before being implemented by doctors; In treatment, you can take it orally, and don't use intravenous therapy. Most antibiotics use penicillin, so stop taking it as soon as possible.
A month passed quickly. Here, I am very grateful to the hospital leaders for providing me with such a valuable learning opportunity, allowing me to contact and learn the advanced medical technology and nursing concepts of the hospital and feel the civilization and advancement of Hong Kong. At present, Dushanzi is in a period of great development. In order to meet the needs of great development, hospitals have continuously sent medical staff to the mainland and Xinjiang to learn advanced management models and medical technologies. I believe that through the joint efforts of all medical staff, Dushanzi Hospital will definitely become a unique brand hospital in the Golden Triangle and better serve the people of Dushanzi!
Summary report of continuing education in hospital 5
I completed a year's study in _ _ hospital. During the study period, I will abide by the rules and regulations of hospitals and departments, respect teachers, unite colleagues, and be strict with myself, so as not to be late, leave early, be absent from work without reason, and leave my post without authorization. I am kind to patients and have a good attitude. I try my best to apply my theoretical knowledge and basic skills to practice. In this process, I constantly sum up my learning methods and clinical experience, strive to improve my ability to think independently, solve problems independently and work independently, and constantly cultivate my lofty thoughts and good professional ethics of serving the people wholeheartedly. Through this study, I improved my level of writing related medical literature. Enhanced the ability of diagnosis and treatment of common and frequently-occurring diseases in internal medicine; Further mastered the treatment methods of dangerous, serious and urgent patients. During this period, I actively participated in the business study organized by learning units and departments, which made my study life more substantial and meaningful. Teachers attach great importance to the cultivation of the younger generation, and the first-line or senior doctors report the medical history first when making rounds; The superior doctor carefully inquired about the medical history, analyzed the possible causes, made further relevant examinations, made a diagnosis and determined the treatment plan. This will enable patients to get reasonable treatment systematically and systematically, and at the same time let young doctors know more. With the care and help of the director of internal medicine and the second-line teachers in all subjects, the rotation of each group was successfully completed. Through study, I have been able to master the diagnosis and treatment of common diseases in internal medicine, and I can independently complete routine operations in internal medicine, such as closed thoracic drainage and pleural biopsy.
A year's study and life is fleeting. In this short year, I was deeply impressed by the First Hospital of xi Jiaotong University, and I also had many feelings and gains. While broadening my horizons and enriching my professional knowledge, I also deeply realized the charm of medical career. I deeply felt the concept of "people-oriented" and advocated humanistic care.
Standardized medical care management and workflow, strict rules and regulations, is the root to put an end to it. The good service attitude of medical staff makes the doctor-patient relationship harmonious. On the basis of perfecting various rules and regulations, the hospital has truly achieved smiling service and thoughtful service. In the ward, medical staff contact patients more, understand their pain and thoughts, and try their best to help them solve problems. The system of ward rounds, discussion of difficult cases and major operations has been gradually implemented and improved. My study life is full and enjoyable, and with many new experiences and gains, my study life has been enriched.
In the days of further study, my professional knowledge has been consolidated and increased, and I have learned many advanced technologies and methods. While I am happy with my efforts and gains, I am determined to bring the knowledge and ideas I have learned back to my post, hoping to apply the new technologies and knowledge I have learned to clinic, such as closed thoracic drainage and pleural biopsy in respiratory department. For patients with massive pleural effusion or repeated pleural effusion, a thinner drainage tube such as central venous catheter can be used for closed thoracic drainage during hospitalization, which can not only reduce the pain caused by thoracic puncture every day, but also save the time and energy of clinicians and better serve other patients. Another example is pleural biopsy, which provides a strong pathological basis for the diagnosis of pulmonary tuberculosis, pleural tuberculosis and chest metastasis of lung cancer, and guides the next treatment well.
In a word, I am satisfied with my further study and full of confidence in my future work. I sincerely hope that you will give me more valuable opinions and suggestions to help me make greater progress!
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