Intensive care unit, is specialized in admitting and treating critically ill patients and giving careful monitoring and precise treatment. Critical Care Medicine (CCM) is a medical specialty that focuses on critical illnesses, is based on the integration of basic medicine and clinical medicine, and applies modern monitoring and interventional techniques to provide a more comprehensive understanding of critical illnesses and ultimately improve the survival rate of critically ill patients by means of effective treatments for critical illnesses. Critical Care Medicine Critical care medicine is the theoretical basis for the work of the intensive care unit, while the intensive care unit is the clinical practice base of critical care medicine.
Nursing is an important part of ICU management, and how to stabilize and improve the quality of care has been a subject of clinical research. As a comprehensive ICU in a tertiary hospital, Shanghai Changhai Hospital
ICU has been utilizing a quality management team to carry out nursing quality control since 2003, and has achieved better results.
Since the establishment of the quality management team to implement management, the quality of nursing care management in this ward has become more detailed and standardized, the management measures are more focused on operability and practicality, and the awareness of quality management ownership of nursing staff at all levels has generally been improved, and the quality of nursing care has stabilized at a high level. In the hospital nursing department organized by the occasional assessment of the full standard, the comprehensive assessment results in the hospital rankings year by year.
Methods
Establishment of quality management team
According to the actual situation of ICU nursing, using the principle of "key quality events" in quality management, and based on the key points of nursing quality management in the ward, we have established a quality management team, which includes the basic nursing care and nursing technical operation, disinfection and isolation, nursing paperwork, drugs and emergency supplies management. Based on the key points of nursing quality management in the ward, six quality management groups have been established, including basic nursing care and nursing technical operation, sterilization and isolation, nursing paperwork, drug and first aid management, instrument management, and clinical teaching. Each group has a team leader and two to three team members according to the workload of each group. All team members have more than 3 years of work experience, strong sense of responsibility, and have certain management ability and dedication; the team leader is a nursing backbone with more than 5 years of
ICU work experience.
Responsibilities of the quality management group
Determine the responsibilities of each group according to the hospital nursing quality control standards. ① Basic Nursing and Nursing Technical Operation Group: responsible for managing the quality of nursing care in the ward, supervising the implementation of nursing technical operation standards, responsible for the implementation of health education and all the transfer of patient satisfaction surveys, etc.; ② Disinfection and Isolation Group: responsible for the quality control of disinfection and isolation in the ward and infection monitoring; ③ Nursing Clerical Group: responsible for checking the standardization and accuracy of the record of medical documents and the archiving and preservation of medical records; ④ Drugs and Emergency Goods Management Group: responsible for the management of emergency goods in the ICU. First aid goods management team: responsible for the inventory, replenishment and validity monitoring of drugs in the ward, inventory and maintenance of rescue equipment, inventory, storage and replenishment of consumables; ⑤ Instrument management team: responsible for the inventory, storage, maintenance and registration of the use of instruments in the ward (such as monitors, ventilators, blood gas analyzers, etc.) to ensure that the instruments are in a state of standby at all times; ⑥ Clinical teaching team: responsible for the teaching of internship nurses and advanced training nurses as well as new nurses; ⑥ Nursing paperwork team: responsible for the teaching of internship nurses, advanced training nurses and new nurses, Clinical Teaching Group: responsible for the development and implementation of the teaching plan for interns, trainee nurses and new nurses, as well as the organization and arrangement of the business study in the ward and the assessment of nurses. The members of each group exercise their duties under the leadership of the team leader to ensure that the quality of nursing care in the hospital district to meet the standards and service satisfaction rate.
Implementation of the quality management team
In the process of implementation, it is stipulated that members of the quality management team should inspect the content of their responsibility at least once a week and record it, and carry out a major inspection under the leadership of the team leader once a month and make a record of it. At the end of each month, the results of the inspection are summarized and analyzed, and corrective actions are proposed and evaluated for deficiencies, and improvement measures are implemented after they are put forward; at the same time, the implementation is tracked and monitored, and the effect of the improvement is observed, and the effective improvement methods are upgraded to operational standards and work norms, so as to gradually achieve the purpose of improving the workflow.
Quality management team assessment
The establishment of the head nurse as the leader of the three-member quality management team supervision group, weekly supervision of the members of the group to check the implementation of the situation. At the same time, in order to improve the quality management team members' work enthusiasm, the monthly quality management team of different degrees of incentives, but only in the Department of Nursing organized by the random inspection of the quality management team members to fully meet the standard will be rewarded. Members who cannot implement the inspection as required, are not impartial, and have poor management skills are replaced at any time.
Analysis
Emphasis on quality management-related education, the formation of the concept of total management is the basis for the development of quality management group management
The effectiveness of the quality management group activities carried out significantly or not depends on the business level of the staff and the level of quality management of staff at all levels. Therefore, in the development of quality management team management should be carried out at all levels of nursing staff to carry out relevant education and training, quality awareness, business techniques and statistical methods and other related knowledge education, in order to form a stable concept of quality, integrated into the quality of the spirit of a district, so as to mobilize the enthusiasm of all staff to the greatest extent possible, so that they consciously and autonomously participate in and cooperate with the activities of the quality management team. At the same time, to carry out quality management team activities is to advocate a quality culture, in this cultural atmosphere, everyone participates in nursing management, everyone cares about the development of the ward, learn to comprehensively and objectively look at the problem, analyze the problem, solve the problem. The implementation of quality management team management, can make nurses timely understanding of their current situation, found weaknesses, timely improvement, improve work efficiency.
PDCA cycle procedure to ensure that the scientific nature of the quality management team activities carried out
In the quality control of the quality management team quality control, focus on the process of nursing services to monitor the quality management team's activities step by step in strict compliance with the PDCA work cycle of quality management, the organization of weekly quality control, monthly summaries, the inspection of the existence of the problem of the parties concerned feedback, and in the Section meeting for evaluation, the existence of problems proposed corrective measures. At the same time, a quality control and supervision group is set up to assess and evaluate the effectiveness of each member's management work, improve the constraint mechanism, and utilize the method of combining assessment and rewards to make nursing staff's personal goals consistent with the goals of nursing management. Through this scientific quality management, to ensure that the improvement of nursing quality is practical and feasible, to avoid deviation, to achieve the purpose of continuously improving the quality of nursing care.
Establishing a sound and perfect quality management team activity system to ensure the continuous development of the quality management team
The perfect quality management team activity system is a necessary condition for the healthy growth of the quality management team. Insist on carrying out quality management team activities with planning, analysis and summarization; record the activities on time and carefully to ensure the authenticity and continuity of the records; analyze and educate the quality problems found by the quality management team; deal with the faults of the relevant personnel and the defects of the process in a timely manner; promote the proposed quality improvement measures; assess the results of the quality management team's activities in phases, and objectively and comprehensively Evaluate the activities of the quality management team in an objective and comprehensive manner; improve the incentive mechanism, and give certain forms of rewards to the quality management team with good activities to stimulate the work enthusiasm. The implementation of quality management team management over the past four years, according to the effectiveness of the management of each group and members of the work of the enthusiasm and initiative to adjust the personnel, the annual organization of the whole section of the members of the work of the state and the effect of the evaluation, to ensure that all members of the quality management team to maximize the management of the strength of the play and application.
Implementation of quality management team management, to achieve a win-win situation for individuals and the collective
Quality management team activities are more frequent than the nursing department inspections and random checks by health agencies, and inspectors are work colleagues, observation and supervision is more direct and easy to find problems. Mutual supervision makes nursing staff at all levels pay attention to the quality of each operation, making the daily operation standardized, avoiding the problems brought by coping with unannounced inspections, which is conducive to the promotion of the stability of the quality level of nursing care. At the same time, the quality management team analyzes and researches through inspections and daily observations, proposes and solves problems, cultivates the problem-solving ability of nursing staff at all levels; strengthens the standardized operating procedures and workflow, increases the enthusiasm of nursing staff to participate in continuing education, and is conducive to the formation of a strong learning atmosphere throughout the entire nursing unit to build a vibrant learning organization.
ICU is a special nursing unit in hospitals that concentrates on treating critically ill patients, which is an important symbol of the hospital's technical level, and the level of nursing quality management directly affects the success rate of treatment for critically ill patients. The implementation of quality management team's management method in ICU of Shanghai Changhai Hospital improves the quality consciousness of nursing staff, helps mobilize the enthusiasm of nursing staff, thus ensuring the continuous improvement and steady enhancement of the quality of supervision, and provides management means to cope with and solve the contradictions of ICU's daily work, which is worth to be promoted and applied by the clinic. It is worthy of clinical promotion and application.
The two key tasks of the quality management team are "team and authorization". On the one hand, the head nurse delegates the authority of quality management to each quality management team, which reduces the work pressure of the head nurse and gives full play to the initiative of nursing staff at all levels, and most of the nursing staff have formed a sense of ownership of quality management and increased their enthusiasm to participate in the management; on the other hand, through the activities of the quality management team, we find out and solve the problems that exist in the daily nursing care, and obtain more suggestions and recommendations during the process of analyzing and discussing. On the other hand, through the quality management team activities, the problems in daily nursing work are found and solved, and in the process of analyzing and discussing, more suggestions are obtained, and benefits are gained from the cultivation of team spirit and so on, which creates high-quality work performance and improves job satisfaction.