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How to do nursing quality managementEstablish standards of care, publicize them,
Require the implementation of the standards, and check them at the right time to collect the opinions of customers (patients);
Update the standards of care when necessary.
Continuous improvement.
How to improve nursing quality managementNursing service standards should be up-to-date and meet the needs of customers (patients);
Nursing staff training in place, strict implementation of the norms
Checking the implementation of the norms and soliciting customers' opinions
Discovering the problems, analyzing the reasons, taking measures to improve the service norms.
Nursing quality management SignificanceNursing quality is an important part of the hospital quality, is one of the important symbols to measure the quality of medical services, is a reflection of the whole medical quality level of the epitome; high and low quality of nursing not only depends on the quality of nursing staff and technical quality, more directly dependent on the level of nursing management, especially the method of nursing quality management. Scientific, effective, rigorous and perfect management method is to ensure the quality of nursing care is the basis for improving the quality of nursing care is an important measure.
Nursing quality management program1, nursing quality management objectives
? Strengthen the patient-centered, quality-centered service concept, adhere to the people-centered, nursing first, highlighting the quality of nursing services, to create Shandong nursing mouth brand, and strive to achieve the nurse-patient relationship of zero distance, zero error in nursing quality, zero defects in nursing technology, nursing services, the goal of zero complaints requirements.
2, nursing quality management standards
? Float upward on the basis of the second-level general hospital accreditation standards. Weekly link inspection, monthly comprehensive inspection, so that the quality of care continues to improve, spiraling upward, the results of the inspection and economic benefits linked to the higher than the passing rate without deducting points, each lower than the passing rate of 1% deducted 1 point. Now the list of the development of standards is as follows:
Item Secondary hospital standards Our hospital to develop standards
First aid items intact rate 100% 100%
Emergency critical rescue ≥82% ≥82%
Successful rate of rescue of critical patients in the ward ≥84% ≥84%
Carrying out the overall care of the number of wards 100% 100% 100%
Basic nursing care pass rate
(Passing standard is 85 points) 100% 100%
Intensive care, the first level of nursing care pass rate ≥85% ≥95%
Critical patient care pass rate 100% 100%
Health technicians "three basic" assessment
Qualified rate 100% 100%Qualified rate of nursing technical operation
(Qualified rate of 85 points) 100% 100%
Annual number of bedsores 0 times 0 times
Intact rate of medical equipment and instruments ≥80% ≥90%
Qualified rate of nursing documents ≥90% ≥90%
Ward management Qualified rate ≥90% ≥90%
Patient discharge satisfaction ≥95% ≥95%
Nursing service satisfaction ≥95% ≥95%
Sterile surgical incision Class A healing rate ≥97% ≥97%
Sterile surgical incision infection rate ≤0.5% ≤0.5%
Routine instrument disinfection sterilization rate 100%
Disposable equipment, instrumentation good rate ≥80% ≥90%
Nursing documents qualified rate ≥90% ≥90%
Ward Management 100%
Disposable syringes, infusion (blood) devices after use disfigurement rate 100% 100% 100%
Hospital infection rate ≤8% ≤8%
Hospital infection underreporting rate ≤10% ≤10%
One person, one needle, one tube, one use, one sterilization
Implementation rate 100% 100%
Hospital infection management rate ≥ 95% ≥ 95%
Hospital infection management rate 95% ≥95%
How to improve the quality of operating room nursing management
The quality of nursing work in the operating room will affect the quality of medical care and patient... Yuan Xi Jianye Hospital Xinglong Health Service Center, Nanjing, Jiangsu Province No. 139, Yanshan Road, 210017 Abstract The operating room is an important room for patients to carry out surgical diagnosis, surgical treatment and rescue tasks. The quality of nursing care in the operating room affects the quality of medical care and the safety of patients. Therefore, the operating room must have strict knowledge of nursing management, sound system and strict aseptic technology management in order to complete all the surgical work in a high standard. Keywords operating room; quality management; hospital infection control I. Aseptic technology management Aseptic technology management is the focus of quality management of the operating room work, but also the key in the management of infection in the operating room, related to the infection of the surgical incision and the patient's postoperative healing, which mainly includes several aspects, namely, the operating room environment (cleanliness of the operating room, air and hand disinfection and monitoring of bacterial cultures, and contaminated surgical post-treatment), the sterilization of the surgical items, the intraoperative cooperation, the disinfection and sterilization, the sterilization and the postoperative treatment of the surgical items. disinfection and sterilization, and intraoperative cooperation of aseptic technology operation. 1 Quality control management of operating room working environment: the control nurse is required to complete air culture, hand culture and object culture every month and record the culture results. After infectious surgery, the operating room should be disinfected in time to prevent airborne transmission, and the contaminated instruments and articles should be thoroughly disinfected and sterilized before use. Surgical instruments used by patients susceptible to cross-infection, such as hepatitis B and syphilis, should be soaked in disinfectant before disposal. Doors, windows, tables, beds and stools in the operating room should be carefully wiped with disinfectant solution. The total number of bacteria in the air culture of the operating room shall not exceed 200 cpu /m3. Sampling bacterial culture of various disinfected (sterilized) items, such as chemical disinfectants and autoclaved items, shall be carried out on a regular basis. Nurses should carefully summarize the quality of disinfection and sterilization and cleaning and hygiene according to the data provided by monitoring, analyze the causes of the problems in time, and at the same time formulate improvement measures and supervise the implementation of all staff. 2 Management of aseptic operation technique: Every move of the operating room staff, i.e., from entering the operating room to hand sterilization and then to each operation link on the operating table a little negligence can lead to the failure of aseptic technique, resulting in surgical infection. Therefore, the serious operation of aseptic technology must rely on all doctors and nurses **** with the completion. 3 Sterilization of surgical items management: the sterilized items, a weekly cleanup, expired instruments, dressings should be re-sterilized, timely addition and replacement, set the date of replacement of various types of items disinfection, implementation of the implementation of the executor. Second, the storage and maintenance of instruments, general instruments are kept by specialized personnel, regular maintenance. Precision instruments are positioned and managed by a designated person, and a registry is adopted with the signature of the user. Consumable dressings are under the responsibility of a designated person, and are added and replenished in a timely manner. Third, preoperative preparation and intraoperative cooperation, to arrange for experienced comrades to work with the instrumentation class to do a good job of preoperative preparation, the establishment of various types of surgical instruments to ensure that the preparation of surgical materials complete, applicable, in line with the requirements. The nurses in the operating room are required to understand the condition, surgical program and method before surgery, and do a good job in the psychological care of surgical patients. During the operation, they should be skillful, active and meticulous. Fourth, the prevention of errors and accidents, the operating room is prone to errors and accidents in more links, such as surgical parts, instrumentation preparation, intraoperative medication and blood transfusion, specimen delivery, etc., any one link of negligence can cause serious consequences for patients and even life-threatening. It is necessary to strengthen the sense of work responsibility, strict job responsibility system, so that people in the post in, who is responsible for who is in the post, sound rules and regulations. At the same time, we should organize professional knowledge and study to improve the ideological understanding so as to achieve the purpose of prevention, and strictly prevent the occurrence of errors and accidents. To organize regular discussions to analyze the reasons for errors. Cite as a warning. Fifth, to cooperate with the head nurse of the overall quality management of all personnel, but also pay attention to keep in touch with the surgical department, regularly to the clinical surgical department for advice, in order to continuously improve and coordinate the work of surgical cooperation. If there are conflicts between departments in the work, they should exchange opinions and support each other in the spirit of all the work and the interests of patients to ensure the coordination of work. Operating room nurses should be modest, sincere attitude, do not blame each other, cooperation and division of labor. Sixth, strengthen business learning, master comprehensive knowledge and skills have a plan to organize the nursing staff to update the operating technology to adapt to the needs of the operation with the head nurse can be based on the individual specifics of the nursing staff, developed a year-long business learning plan, monthly designated personnel lectures, the content of the operating room professional theory. Requirements both emphasize professionalism and relevant theoretical disciplines, combined with clinical practice, demonstration of operation, so that the theory and practical operation, and strive to learn to use, better to do a good job with the operation such as the development of new surgeries. The use of new equipment, new instruments, please special lectures to master the steps and methods of surgery, the use of the surgical process and instruments and instruments to cooperate in the process of surgery is comfortable, organized and successful completion of the surgical work. 1 Zhang Hanhong, Song Feng, Zhang Xiaonuan. Methods of monitoring the quality of nursing care in the operating room, Chinese Journal of Nursing, 2002;37(8):614~6152 Wei Ge, Liu Sujun. Nursing in the operating room. Beijing: people's military medical press. 2003,68
Seek nursing quality management systemBaidu search.
How to improve the quality of nursing care managementThe quality of nursing care is the eternal theme of nursing work, is the core of nursing management. Nursing quality is an important part of the quality of medical care, but also to measure the quality of medical services is one of the important signs. Nursing quality not only depends on the quality of nursing staff and technical quality, more directly dependent on the level of nursing management, especially the method of nursing quality management. Scientific and effective, rigorous and perfect management method is the basis for ensuring nursing quality. The head nurse of the ward, as the most basic clinical manager, plays an important role in the nursing management of the department. How to improve the quality of nursing care in the department, I have the following understanding. First, improve the quality of business. Heavy nursing staff self-cultivation, improve the theoretical level and business technical skills. First, combined with the needs of specialty development to select and send outstanding nurses for further study, according to the department, reasonable arrangements for nurses to ICU and electrocardiogram learning, in order to improve the nurses' ability to cope with critical emergency patients. The second is to strengthen the on-the-job training, through the monthly nursing room, business learning to constantly master the new theoretical knowledge and technology; the implementation of responsible nurses to participate in the group of doctors room; to strengthen the nurses three basics, specialized theoretical knowledge, the core system, the study of emergency preparedness and the technical operation of the training, a strict examination system, the results of each examination and the nurses of the monthly examination and bonuses linked to the strengthening of nurses to a variety of medical and technical examination of essential knowledge of the nursing before learning, in order to improve the ability of health education. To strengthen the nurses' knowledge of nursing care before various medical and technical examinations, to improve the ability of health promotion; weekly discussion of medical records is organized by the head of the whole nursing team to improve their comprehensive analysis ability. Thirdly, encourage self-learning, encourage and support nurses to participate in nursing undergraduate self-study exams to improve the level of education and their own quality. Second, enhance legal awareness, strengthen the sense of responsibility. A high degree of responsibility is to improve the quality of care is an important element, nursing staff should be serious and responsible attitude towards patients. Strengthen the legal awareness education and training for nurses and practical nurses to improve the legal awareness of nursing staff. Nursing errors and accidents are largely caused by a weak sense of legal awareness and a weak sense of responsibility at work. Most of the nurses' work is to complete nursing work alone without leadership supervision, therefore, having a high sense of responsibility and good prudent spirit is the guarantee to avoid error accidents. Individual legal awareness is weak, work responsibility is not strong nurses, should especially strengthen the education. Third, improve the rules and regulations to implement the core system. Develop and improve the rules and regulations, the duties of all kinds of personnel in each class, the standard of work, so that each class of nurses have a chapter to follow, have a system to check. On the ward of the hierarchical nursing system, checking system, shift handover system, nursing medical record writing standard system, etc., seriously organize learning, strict implementation. All rules and regulations should be observed by everyone. Strictly according to the nurses monthly assessment standards and compliance with the various systems in the department to assess the performance of each nurse, the results of high and low and bonus linked to the selection of outstanding nurses and advanced workers according to the score. Fourth, play the role of quality control team supervision and inspection. According to the characteristics and ability of each nurse, the nursing quality control team is established to assist the head nurse in supervising and checking the case management, ward management, basic nursing care, special nursing care, teaching management, first aid management, etc., so as to realize that everyone has a special responsibility, and there is a person who takes care of everything, so as to realize the tasks and responsibilities of the nursing work to each post and each person. Regularly convene a regular meeting every month to analyze the results of nursing quality inspection, summarize and analyze the situation of various nursing inspections in the month, put forward corrective measures, and formulate corresponding uniform regulations for the existing **** problems, reflecting the concept of process control and continuous improvement. Fifth, the scientific and rational use of human resources. In the case of insufficient nursing staffing, the head nurse to do a good job of flexible scheduling, in the arrangement of nurses' work positions to do a combination of old and new, collaborate with each other, and give due consideration to the quality of the personnel and the reasonable distribution of high and low levels of technical skills. Contribute to the coordination of nursing staff relations, play complementary, improve the quality of nursing group. Sixth, monitoring key links. Nurse manager will nursing errors, nursing disputes prone to the link as a nursing risk management focus on the implementation of management. For example, the management of "key nurses": the basic skills are not solid, poor overall quality, poor service consciousness of the nurses need to strengthen the teaching, strengthen supervision and guidance: "key moments" management: such as the number of patients with serious illnesses, treatment and care of a large number of (or) few nursing staff. The situation should strengthen the organization and management and staffing, if necessary, can report to the nursing department to give support, strengthen the first aid items check to ensure that complete, holidays, strengthen the check, line up a good first aid nurses, in order to cope with the occurrence of emergencies. Focus on details, eliminate hidden dangers, reduce nursing errors and accidents, nursing complaint rate, and avoid medical disputes. Seven, strengthen the nurse service concept. With the development of medical model and socio-economic development, the patient's expectation of nursing is also increasing. How to improve patient satisfaction is also an important standard for measuring nursing quality. Strengthen the nurse's active service consciousness, set up "let the patient smile at us" service concept. Take the initiative to communicate with patients, help patients to solve some practical difficulties, so that patients are in the best state to receive treatment and care during hospitalization. Dealing with the doctor-patient relationship follow the "fault in me" principle, the "right" to the patient, where adverse to the image of the hospital and the department of the people and things, reasonable and unfavorable, not to argue with the patient. When the patient dissatisfaction or controversy, the nurse is not required to argue with the patient face to face, by the director, the head nurse to facilitate the resolution of the problem. Improvement of patient satisfaction, reflecting the improvement of the quality of nursing services, not only for the hospital has won good social benefits, but also achieved good economic benefits. Eight, to create a combination of strict and wide environment. Work must be "strict" word at the head, remove the "fear" word, in order to improve the quality of care. Criticism should also speak on the art, many nurses in the character of each, the level of ideological understanding is also different, to accept the criticism of the head nurse reflected in different attitudes, therefore, the head nurse should be based on the nature of the problem and the nurse's character to take a different way of criticism. But in the life of the nurses to do their best to solve problems, understand their needs, as they are like a mother, like to sisters, so that they feel warm in the department work. Every month to find 1-2 nurses to talk about, understand the nurses thought dynamics, life difficulties, seek nursing improvement measures. After work, the organization of departmental activities, relieve work pressure, harmonious relationship between colleagues. Enhance the collective sense of honor to carry forward the good team spirit. Solidarity, mutual support and trust is an important guarantee to improve the quality of our nursing. The complexity and diversity of nursing work is objective, nursing management should be based on strict quality control. To focus on the quality of each element to coordinate the overall situation; specific grasp link quality, pay attention to the end of the quality, quality feedback control, to improve the nursing work, improve the quality of the purpose of medicine, 敎育网收集整理.
How to carry out nursing quality management and continuous quality improvement
The focus of quality management is two: prevention and improvement.
Prevention is the action before the problem occurs; improvement is the action after the problem occurs.
The key role of PDCA is prevention, for example, a mold company to design a new set of molds, then for the set of molds designed before the design, the design process of all the design of the problem points and difficulties listed, and the development of improvement measures for these expected problem points, once the problem points occurred, these things play a role.