In order to effectively carry out the hospital's responsibility to save lives and help the injured, standardize the medical behavior of medical personnel to rescue critical patients, and prevent the occurrence of unsafe medical liability events, this system is hereby formulated:
(a) Due to a variety of reasons or diseases leading to the emergence of patients with vital signs of a serious morbid state, which threatens the patient's life, or in the process of treatment there is the possibility of accident and complications that threaten the patient's life safety is regarded as a critical patient. complications that threaten the patient's life are considered to be critically ill.
(2) Critically ill patients are responsible for the first consultation, and the first physician and medical department must be responsible for the patient's first aid and the maintenance of vital signs until the implementation of a specialized medical department and physicians for diagnosis and treatment.
(3) critical patient rescue must listen to the person in charge of the emergency team or the physician in charge of the command, and quickly transfer the patient to the emergency room and ICU for treatment, especially urgent to try to transfer should be on-site rescue, emergency ambulance and the hospital emergency team rushed to the rescue.
(d) in the hospital accidents and serious complications lead to critical state of the patient or critical patient resuscitation requires special administrative support, in addition to the third disposition, must be immediately reported to the Medical Office until the President.
(E) the transfer of critically ill patients must be accompanied by competent health care personnel or preside over the diagnosis and treatment operation of health care personnel, according to the condition of the physician in charge of the decision to escort the medical level, please accompany the nurses need to be accompanied by verbal or written form of medical advice. The nurse must be accompanied by a verbal or written order. The absence of such an order is considered to be accompanied by the person in charge. Nurse station must do a good job of coordination.
(F) each medical department must form a rescue team by the head of the section personally presided over. Each ward must establish a regular inspection of first aid equipment, medicine system, the Pharmacy Department to ensure that at any time to provide adequate first aid medicines, auxiliary departments to ensure that first aid inspection equipment in good condition and at any time emergency and establish a system.
(VII) Emergency Department and ICU is an important department of hospital disposal of critically ill patients, must ensure emergency beds and equipment for emergency use and emergency call of personnel. The department must establish a corresponding regular inspection of the medical system.
(VIII) critical care patients in emergency all medical personnel should be to save the patient's life as the first, received emergency paging 6120, put down all work to rush to the emergency places. In order to save lives, the person in charge of the rescue has the power to sign the "emergency first aid" opinion, first treatment and then pay, but this authority is limited to the first time. After the exercise should be immediately reported to the medical administration and the general duty, the future does not pay for treatment need to ask the medical administration for approval.
(ix) If the violation of the above regulations is considered a liability event, the hospital will be severely punished, and the consequences arising from this, the parties concerned will be held legally responsible.
2. Three-tier checkup system
(a) The department director, chief physician or attending physician checkups should be attended by residents, head nurses and relevant personnel. The department director, chief physician room check no less than 1~2 times a week, attending physician room check 2-3 times a week, room check is usually carried out in the morning. The resident physician to the patient under his control at least twice a day room check.
(2) For critically ill patients, residents should always observe the changes in their condition and deal with them in a timely manner, and if necessary, they may ask the attending physician, department head, or chief physician to check the patients temporarily.
(3) Before checking the room, medical staff should do a good job of preparation, such as medical records, X-ray films, all relevant examination reports and the required examination equipment. When checking the room should be strictly required from top to bottom level by level, serious and responsible, the treated resident should report a brief medical history, the current condition and put forward the problems that need to be solved. The director or attending physician can do the necessary examination and condition analysis according to the condition, and make affirmative instructions.
(d) The head nurse organizes nursing staff to conduct a nursing check-up once a week, mainly to check the quality of nursing care, study and solve difficult problems, combined with practical teaching.
(E) the contents of the room:
1, the director of the department, the chief physician room, to solve difficult and critical cases, review of new admissions, difficult and critical patients diagnosis, treatment plan, decide on the major surgery and special examination and treatment; random inspection of the medical advice, medical records, quality of care; listen to the physician, nurses, the views of diagnosis and treatment and nursing care; to carry out the necessary teaching work. The deputy chief physician of the new general patients in the first checkup should be mentioned, including the diagnostic basis of the disease, differential diagnosis, treatment program and the treatment process should pay attention to four aspects of the content of the difficult cases should be mentioned in the clinical symptoms, signs, laboratory results in the differential diagnosis of the significance of the diagnosis and clear diagnostic pathways, measures and methods: the patients who have been issued a "critical" notice, it is important that the patient should be informed of the "critical condition" of the patient.
The patient who has been notified of "critical illness" should be examined every day for three consecutive days starting from the same day, and the examination should mention the main contradiction of the current situation as well as the ways, measures and methods to solve the main contradiction.
2, the attending physician checkup: required to manage the patient group systematic checkups, especially for new admissions, critical, diagnosis is not clear, the treatment effect of bad patients to focus on the inspection and discussion, listen to physicians and nurses, listen to the patient's statement, check the patient's medical records and correct the wrong records; to understand the changes in the condition of the patients and ask for their views on diet, life; check the implementation of medical advice and treatment effects, and decide to discharge! The patient's condition and the effect of treatment are checked, and decisions are made on discharge and transfer to other hospitals.
3, resident room visits, to focus on the inspection of critical, difficult, to be diagnosed, new admissions, post-surgery patients; check the laboratory report card, analyze the results of the examination, and put forward the views of further examination or treatment, check the implementation of the day's medical advice; to give the necessary temporary medical advice and write the next morning special examination of the doctor's orders; check the patient's diet; take the initiative to seek the patient's views on the medical care, nursing and life, and so on. It is a good idea to ask for the patient's opinion on medical treatment and nursing life.
(6) hospital leaders and functional department heads, there should be a plan and purpose to regularly participate in the department of the room, check the patient's treatment and all aspects of the problem, and timely research to solve.
3. Consultation system
(a) Whenever a difficult case requiring consultation is encountered, consultation should be applied for in a timely manner.
(2) Interdisciplinary consultation: proposed by the physician, the superior physician agreed to fill out the consultation form, the physician in charge of accompanying the consulting physician to examine the patient, and make a brief history. The invited physician should generally be completed in twenty-four hours, and write a consultation record. If the need for specialist consultation of mildly ill patients, the patient may be allowed to specialist examination.
(3) Emergency consultation: the invited person must be on call and must arrive at the place of consultation in time after being notified of the consultation.
(4) Intra-departmental consultation: proposed by the treating physician or attending physician, the department head calls the relevant medical personnel to participate.
(E) hospital consultation: proposed by the department head, agreed by the Medical Department, and determine the consultation time, notify the relevant personnel to participate. Generally by the director of the applicant section hosted, the Medical Office to send people to participate.
(F) out-of-hospital consultation: the hospital can not be diagnosed and treated difficult cases, proposed by the director of the department, agreed by the Medical Department, and contact with the relevant units to determine the consultation time, consultation by the director of the applicant department to preside over. If necessary, carry medical records, accompanied by the patient to the out-of-hospital consultation; can also be medical records, sent to the relevant units, remote consultation.
(VII) the collective consultation within the department, the hospital, outside the hospital: the physician should do a good job in the preparation of the consultation and consultation records, a detailed introduction to the medical history. Participating physicians should examine the patient in detail, carry forward the technical democracy, and clearly put forward the consultation opinion. The host should make a summary, consultation opinions should be carefully organized and implemented.
4. Graded care system
(I) Purpose
Graded care means that according to the patient's condition, to determine the special level of care or one, two or three levels of care, to carry out observation and treatment care, and according to the ability to perform daily life (ADL) assessment to give basic care.
(2) Scope of application
1. Extraordinary care
(1) Organ failure (heart, brain, kidney, liver, and respiratory failure).
(2) All kinds of complex or new major surgery.
(3)All kinds of severe trauma, burns, and multiple organ function injury.
2, the first level of care
Severe or unstable condition requires close monitoring and observation.
3, secondary care
Basically stable condition.
4, tertiary care
Stable condition.
(C) Main nursing requirements
1, special nursing requirements
(1) Specialized nursing care or transfer to ICU.
(2) Monitoring vital signs and discharge according to the condition.
(3) Closely observe changes in condition and keep records of important physiologic and psychological responses of the patient.
(4) Accurately carry out medical orders and complete treatment in a timely manner.
(5) Doing basic and specialized nursing care to prevent nursing complications.
2, the first level of nursing requirements
(1) closely observe the changes in the condition, according to medical advice and condition monitoring records of vital signs, out of people.
(2) Observe the patient's physiological and psychological responses, understand the psychological needs, and do a good job of physical and mental overall care.
(3) Accurately execute medical instructions and complete treatment in a timely manner.
(4) To do a good job of disease-related specialty care and prevent nursing complications.
(5) Perform health education and assist or guide functional exercise.
3, secondary care requirements
(1) Observe the patient's condition changes and physiological and psychological responses, do a good job of physical and mental care.
(2) Accurately implement the medical advice and complete the treatment in time.
(3) Doing health education, assisting or guiding functional exercise, and preventing nursing complications.
4, the third level of care requirements
(l) accurate implementation of medical advice, timely completion of treatment.
(2)Understand the patient's condition and do health education.
(4) Assessment of ability to perform activities of daily living (ADL) and nursing requirements
Nurses should assess the patient's ADL and provide appropriate nursing care.
1. Levels
(1) Level 1: Fully independent, all activities can be completed safely within a normal time. They can take care of themselves without help.
(2) Level 2: Partially independent, need to use assistive devices in completing daily life activities and exceed the normal time to complete the activities, and the movement is not safe enough. Can take care of himself/herself if provided with necessary items.
(3) Level III: Partially dependent, unable to complete daily activities independently despite best efforts. Requires guidance, supervision or persuasion to assist in life care and functional exercise.
(4) Level IV: Totally dependent, needs help completely. Needs assistance with passive activities and guidance with some active activities.
2. Nursing quality standard
(1) Bed is flat, clean, comfortable, free of debris, urine stains and blood stains.
(2) The lying position is comfortable, in line with the condition and treatment requirements.
(3) Oral cleanliness, proper treatment of oral mucosal ulcers and bleeding.
(4) Clean, intact and unbroken skin, clean and odorless perineum and anus, and clean fingers, toenails and whiskers.
(5) Satisfaction of the need to eat.
(6) Satisfy the need for drinking and defecation.
(7) Assist and guide appropriate functional exercises based on limb function.
5. Duty and handover system
(1) Physician duty handover and handover system for critically ill patients
1. Each department must have a physician on duty during non-office hours and holidays. In principle, the resident should be the first line of duty, the attending physician as the second line, the deputy chief physician can participate in the third line of duty.
2, the duty physician should be half an hour in advance to the post, to accept all levels of physician's handover, handover, should visit the ward. Critically ill patients, should be handed over at the bedside.
3, the physician before the end of the shift, should be new patients and critical patients and the handling of matters recorded in the shift book, the physician on duty should also be on duty during the changes in the condition of the treatment of the disease in the course of the record, and at the same time, focusing on a brief account of the shift book.
4, on duty during the emergency admissions, in principle, to complete the medical record in a timely manner, such as the need for emergency treatment or emergency surgery is too late to write the medical record, should be recorded for the first time in the medical record, and then according to the time to make up for the writing of the medical record.
5, on-duty physician on duty during the shift, must be responsible for all temporary medical work and temporary treatment of patients, in the event of difficult problems should be asked to higher physicians to deal with.
6, the physician on duty must adhere to the post, shall not be absent without leave, shall not just find someone to take over, there are special circumstances by the chief resident or the chief of the department approved and confided in the work before switching.
7. If the physician on duty needs to leave temporarily, he should explain to the nurse on duty where he is going, and go to the clinic immediately when the nursing staff calls.
8, the duty physician is generally not out of the daily work, such as rescue patients or other special reasons do not get a break, after the discretion to be appropriate to make up for the rest.
9, every morning, the physician on duty will be the patient's condition and treatment of the situation to the attending physician or chief physician report, and to the attending physician to clear the situation of critically ill patients and the work to be handled.
10, the physician on duty every night at 9:30 with the nurse on duty *** with the room, including a comprehensive inspection of the companion, ward health and safety.
(2) the relevant departments on duty shift handover system
1, pharmacy, testing, radiology, electrocardiogram room and other departments on duty, should be 15 minutes ahead of time to the post, stand firm, and shall not be absent without leave.
2, do a good job with the instruments and apparatus used for shift work and recorded in the duty book.
3, due diligence, to complete all the work of the class, to ensure the smooth progress of clinical medical work.
4, in case of special circumstances need to temporarily leave the department, should be to the hospital general duty to explain the direction, in order to find, to avoid affecting the work.
6. Difficult cases discussion system
(a) five days after admission can not be diagnosed, the need for intra-departmental discussions; eight days after admission failed to diagnose, the need to organize hospital-wide discussions.
(2) Discussion of cases with unsatisfactory efficacy: if the main condition cannot be controlled, intra-departmental discussion should be completed within five days; if it still cannot be controlled, hospital-wide discussion should be completed within eight days.
(3) outpatient case discussion: all in our hospital three visits still can not be clearly diagnosed, to organize the relevant departments to discuss.
(D) medical and technical case discussion: where difficult cases, or found results are clearly abnormal, the report is in doubt, to organize a discussion, retesting if necessary, and by the deputy director of the medical (technical) examined and issued.
(E) critical case discussion: critically ill patients to be completed within 24 hours of the departmental discussion; the condition can not control the requirements of the medical service to organize hospital-wide consultation, the medical service organization to complete the hospital-level discussion within 24 hours.
7. Emergency and critical patient rescue system
(a) the rescue of critical patients, generally by the chief of the department, the (deputy) chief physician is responsible for organizing and presiding over the rescue work. The chief of the department or (deputy) chief physician is not in, by the title of the highest physician to preside over the rescue work, but must promptly notify the chief of the department or (deputy) chief physician. Special patients or the need for inter-disciplinary rescue patients should be promptly reported to the Medical Department, Nursing Department and Vice President of Operations, in order to organize the relevant departments **** with the rescue work.
(2) critical patients shall not be postponed on any pretext, must go all out, every second, and do serious, serious, meticulous, accurate, timely and comprehensive records. Involving legal disputes, to report to the relevant departments.
(3) to participate in the rescue of critically ill patients must be a clear division of labor, close cooperation, each in its own way, to unconditionally comply with the presiding rescue worker's medical advice, but on the rescue of the patient's beneficial suggestions, can be submitted to the presiding rescue personnel identified for use in the rescue of the patient.
(4) the nursing staff to participate in the rescue work should be under the leadership of the head nurse, the implementation of the rescue worker's instructions, and closely observe the changes in the condition, at any time the implementation of the medical advice and changes in the condition of the report of the presiding rescuer. The implementation of verbal medical advice should be recited once, and with the physician to check the drugs after the implementation, to prevent the occurrence of errors and accidents.
(E) strict implementation of the shift handover system and checking system, day and night there should be a person in charge of the condition of the resuscitation process and a variety of medication to be detailed account of the empty ampoule of the drugs used by two people to check before discarding. All kinds of resuscitation articles and instruments should be cleaned up, sterilized, replenished and returned to their original places in time after use, so that they can be used again. Resuscitation room should be final sterilization.
(6) Arranging authoritative specialists to explain the patient's condition and prognosis to the family or unit in a timely manner, and timely processing of a variety of signature procedures, in order to obtain the cooperation of the family or unit.
(7) the need for inter-disciplinary rescue of critical patients, in principle, by the medical office or vice president of business rescue work, and designated to preside over the rescue workers. Participate in the inter-disciplinary rescue of patients in various disciplines should be committed to the use of undergraduate specialties in the patient's rescue work.
(H) not to participate in the rescue work of the medical staff shall not enter the rescue site, but must do a good job of the logistics of the rescue.
(ix) during the rescue work, pharmacy, testing, radiology or other special inspection departments, should meet the needs of clinical rescue work, shall not be refused or postponed on any pretext, logistics departments should ensure the supply of water, electricity, gas and so on.
8. Pre-operative discussion system
(a) for major, difficult (four, special operations) and new operations, scientific research projects, larger destructive surgery, surgery for patients aged 75 years old or older, pre-operative discussion must be carried out.
(2) The preoperative discussion should be recorded in detail, and must clarify the indications for surgery, formulate the surgical program, preventive measures for complications, postoperative observation matters, nursing requirements, etc.
(3) After the discussion of the preoperative medical record must be confirmed by the signature of the director of the department.
9. Death case discussion system
(a) All death cases, generally within one week after the death of the discussion, special cases should be discussed in a timely manner. Autopsy cases, to be discussed after the results of autopsy, but not later than two weeks.
(2) the death of the medical record to make a detailed record of the discussion, including admission, treatment, deterioration of the cause of death, cause of death, time of death. The cause of death is unknown should be noted.
(c) If the death record is a record of infectious diseases, it should be reported to the hospital's Prevention and Protection Section and the Medical Department within the statutory time limit, and a class of infectious diseases should also be reported to the head of the hospital department.
10. Medical checking system
Checking system is to ensure the safety of patients, to prevent the occurrence of errors and accidents an important measure. Hospital workers in the work must have a serious attitude, focused thinking, skilled business, strict implementation of the three check seven system, whether directly or indirectly for the patient's various treatment, inspection items (such as drugs, dressings, instruments, compressed gases, and treatment, first aid and guardianship equipment, etc.), must have the name of the formal and clear marking, with the official state authorization number, factory marking, date, retention period, the appearance of the items meets the safety requirements. The appearance of the goods meets the safety requirements. Where the handwriting is unclear, incomplete, unclearly labeled and doubtful, use should be prohibited. In the use of the process of patients such as discomfort and other reactions, must be immediately discontinued, once again to check the work, including the application of all items, until the cause is found.
(I) checking system for surgical patients
1, when the operating room picks up the patient, it should check the department, bed number, hospitalization number, name, gender, age, diagnosis, name of the operation and the part (left and right) and its sign.
2, surgical staff before surgery again check the section, bed number, hospitalization number, name, gender, age, diagnosis, surgical site, anesthesia and medication.
3, the relevant personnel to check the sterilizing index in the sterile bag, whether the surgical instruments are complete, all kinds of supplies category, specifications, quality is in line with the requirements.
4, where the body cavity or deep tissue surgery, to be sutured by the instrumentation nurse and visiting nurse to strictly check the number of large gauze pads, gauze, thread rolls, instruments and the number of preoperative number of matching, after checking the surgeon can notify the surgeon to close the surgical incision, to prevent the foreign body will be left in the body cavity.
(2) the relevant departments checking system
1, Laboratory checking system
(1) to take the specimen, check the department, bed number, hospitalization number, name, gender, age, the purpose of the examination.
(2) When collecting specimens, check the department, bed number, hospitalization number, name, sex, union number, quantity and quality of specimens.
(3) When testing, check whether the test item, laboratory order and specimen match.
(4) After the test, review the results.
(5) Issuing the report, checking the department and ward.
2, blood bank checking system
(1) blood typing and cross-matching test, two people work to "double checking and double signing", one person work to redo.
(2) When issuing blood, check with the blood collector *** with the department, ward, bed number, hospitalization number, name, blood type, cross-test results, blood bag number, date of blood collection, blood quality.
(3) After issuing blood, the recipient's blood specimen is retained for 24 hours for necessary checking.
3. Pathology checking system
(1) When collecting specimens, check the unit, hospitalization number, name, sex, age, union number, specimen, fixative.
(2) When making a preparation, check the number, specimen type, clinical diagnosis, and pathologic diagnosis.
(3) When issuing the report, review the examination items, results, patient's name, sex, age, hospitalization number, and department.
4, Radiology Department checking system
(1) When checking, check the department, ward, name, film number, site and purpose.
(2) When issuing the report, check the diagnosis of the examination item, patient's name, and department.
5. Physical Therapy Department and Acupuncture Room Checking System
(1) When various treatments are given, check the department, ward, hospitalization number, name, gender, age, site, type, dose and time.
(2) For low-frequency treatment, check the polarity, amount of electricity, and number of times.
(3) When high-frequency treatment, check for metal foreign bodies within the body surface.
(4) Before acupuncture treatment, check the number and quality of needles, and check the number of needles and the presence of broken needles when removing needles.
6. Special examination department checking system
(1) When checking, check the department, bed number, hospitalization number, name, gender, age, and purpose of examination.
(2) When diagnosis is made, name, number, clinical diagnosis, and examination results are checked.
(3) When issuing a report, review the department, ward, hospitalization number, bed number, name, sex, age, examination purpose, and results.
7. Pharmacy checking system
(1) Before formulating, check section, bed number, hospitalization number, name, gender, age, date of prescription.
(2) When formulating, check the content of the prescription, drug dosage, content, and contraindications.
(3) when issued, the implementation of the "four checks, an account": ① check on the name of the drug, specifications, dosage, content, usage and prescription content is consistent; ② check on the label (bag) and the contents of the prescription is consistent; ③ check the drug packaging is intact, there is no deterioration. Ampoule of injection has no cracks, a variety of signs are clear, whether or not the expiration date; ④ check the name, age; ⑤ explain the use and precautions.
11. Surgical Safety Verification System
I. Surgical Safety Verification is a tripartite (hereinafter referred to as tripartite) verification of the patient's identity and surgical site by the qualified surgeon, anesthesiologist and operating room nurse before anesthesia is administered, before the start of the surgery and before the patient leaves the operating room, **** the same verification of patient identity and surgical site.
Second, this system applies to all levels and types of surgery, other invasive operations can refer to the implementation.
Three, surgical patients should be equipped with patient identification information labeled with a patient identification information for verification.
Four, surgical safety verification by the surgeon or anesthesiologist presided over by the tripartite **** with the implementation and fill out the "surgical safety verification form".
V. Implementation of the content and process of surgical safety verification.
(A) anesthesia before implementation: three parties in accordance with the "Surgical Safety Verification Form" in order to verify the patient's identity (name, gender, age, case number), surgical procedures, informed consent, surgical site and marking, anesthesia safety checks, skin integrity, skin preparation of the operative field, the establishment of venous access, the patient's history of allergies, results of antibacterial drug skin test, preoperative blood preparation, prosthesis, implants, imaging data and so on. implants, imaging data, etc.
(2) Before the start of surgery: the three parties **** with the verification of the patient's identity (name, gender, age), surgical methods, surgical site and marking, and to confirm the risk of early warning and other content. Verification of the readiness of surgical items is performed by the operating room nurse and reported to the surgeon and anesthesiologist.
(c) Before the patient leaves the operating room: the three parties **** the same verification of the patient's identity (name, gender, age), the actual mode of surgery, the verification of intraoperative medication and blood transfusion, inventory of surgical supplies, confirmation of surgical specimens, checking the integrity of the skin, arterial and venous access, drainage tubes, and confirmation of the patient's destination and other content.
(iv) The three parties confirm and then sign the Surgical Safety Verification Form respectively.
Sixth, surgical safety verification must be carried out in accordance with the above steps in turn, each step of the verification is correct before the next step of the operation, not to fill out the form in advance.
VII. Verification of intraoperative medication and blood transfusion: the anesthesiologist or the surgeon will give the medical advice and make the corresponding records according to the needs of the situation, and the nurse in the operating room will verify with the anesthesiologist***.
VIII, hospitalized patients, "surgical safety verification form" should be filed in the medical record for safekeeping, non-hospitalized patients, "surgical safety verification form" by the operating room is responsible for preserving one year.
Nine, the head of the Department of Surgery, Department of Anesthesiology and the operating room is the first person responsible for the implementation of the surgical safety verification system in the department.
X. The relevant functional departments of medical institutions should strengthen the supervision and management of the implementation of the institution's surgical safety verification system, and put forward measures for continuous improvement and implementation.
12. Surgical hierarchy management system
(a) Class I and II surgeries are approved by the attending physician in charge (in the absence of the attending physician, the designated senior resident for approval) decided to arrange for surgical staff.
(2) Category III and IV surgeries are approved and scheduled for participation by the division chief or the chief resident.
(c) The use of implantable interventional medical devices requires the approval and signature of the director of the department in which they are used.
(d) Destructive surgery, major special category and new surgery should be signed by the department director, reported to the Medical Office for registration, review and approval of the business dean.
13. Access to new technologies and projects
In order to strengthen the management of medical technology, promote the progress of health science and technology, improve the quality of medical services, to protect the health of the people, according to the "Regulations on the Administration of Medical Institutions" and other relevant state laws and regulations, combined with the actual situation of the hospital, the development of this medical technology access system. Any introduction of new technologies and new projects not yet carried out by the hospital shall strictly abide by this access system.
First, seriously implement the medical technology access management system.
Second, the new technology, new projects to implement the declaration system, the declaration must include the project feasibility analysis, risk prediction, preventive measures.
Third, the establishment of medical technology research and approval system. The use of implantable interventional medical devices signed by the attending physician conversation, the use of implantable interventional medical devices to support and maintain life by the head of the department to sign the opinion of the Medical Department for approval. Destructive surgery, major special type of surgery, new surgery signed by the director of the department, reported to the Medical Office registration, review, business dean approval before implementation.
Fourth, each new technology, new projects should be supported by the corresponding technical force, equipment and facilities. When the new technology, new projects, technical force, equipment, facilities change, may affect the safety and quality of medical technology, should suspend the technology; conditions ripe for reassessment, in line with the provisions of the re-development.
Fifth, the establishment of medical technology risk warning network direct reporting mechanism. Project leaders should be carried out in the process of new technology to carry out various key aspects of risk prediction, once the accident occurred, should be reported through the network early warning system, and actively take appropriate measures to minimize the risk.
Sixth, the newly developed new technologies and projects must comply with ethical and moral norms, and fully respect the patients' right to know and right to choose in the process of scientific research and pay attention to the protection of patient safety.
Seventh, the hospital encourages the research, development and application of new medical technologies, and encourages the introduction of advanced medical technologies at home and abroad; prohibits the use of technology that has been significantly outdated or is no longer applicable, and needs to be eliminated, or is not compatible with the protection of the health of citizens in terms of technicality, safety, efficacy, economy, and social ethics and law.
14. Critical Value Reporting System
(2) Electrocardiogram "Critical Value" Items and Scope
1. Cardiac Arrest
2. Acute Myocardial Ischemia
3. .fatal arrhythmias
(1) ventricular tachycardia
(2) multiple, RonT-type premature ventricular beats
(3) ventricular arrests of greater than 2 seconds
(4) frequent premature ventricular beats with prolonged Q-T intervals
(5) preexcitation with rapid atrial fibrillation
(6) ventricular rate of greater than 180 beats per minute Tachycardia
(7)High, third-degree atrioventricular block
(8)Bradycardia with a ventricular rate of less than 45 beats/min
(3) Medical Imaging "Critical Value" Items and Scope of Reporting:
1.Central Nervous System:
(1)Severe intracranial hematoma, contusion, or other serious injury. Intracranial hematoma, contusion, subarachnoid hemorrhage in the acute stage;
(2) subdural/extradural hematoma in the acute stage;
(3) cerebral herniation, acute hydrocephalus;
(4) intracranial acute large-scale cerebral infarction diagnosed by craniocerebral CT or MRI scans (the scope of which reaches the extent of one lobe or the whole brainstem or more);
(5) cerebral hemorrhage or Cerebral infarction review CT or MRI, the degree of hemorrhage or infarction is aggravated, and the contrast with the recent film exceeds 15% or more.
2. Severe bone and joint trauma:
(1)Spinal fracture diagnosed by X-ray or CT examination, angular deformity of the long axis of the spine, vertebral body comminuted fracture compression of the dural sac leading to spinal stenosis, spinal cord compression. Spinal fracture with angular deformity of the long axis of the spine;
(2) Multiple rib fractures with pulmonary contusion and or fluid pneumothorax;
(3) Fracture of the pelvic ring.
3. Respiratory system:
(1) tracheal and bronchial foreign body;
(2) pneumothorax and liquid pneumothorax, especially tension pneumothorax (compression ratio of more than 50% or more);
(3) pulmonary embolism, pulmonary infarction;
(4) atelectasis on one side of the lung;
(5) acute pulmonary edema.
4. Circulatory system:
(1) pericardial tamponade, mediastinal swing;
(2) acute aortic coarctation aneurysm;
(3) rupture of the heart;
(4) rupture and hemorrhage of mediastinal vessels;
(5) acute pulmonary embolism;
5. Digestive system:
(1) Esophageal foreign body;
(2) Acute gastrointestinal perforation, acute intestinal obstruction;
(3) Acute biliary obstruction;
(4) Acute hemorrhagic necrotizing pancreatitis;
(5) Contusion and hemorrhage of the liver, spleen, pancreas, kidneys, and other abdominal organs;
(6) Intussusception.
6. Maxillofacial and five sensory emergencies:
(1) foreign body in the orbit or eyeball;
(2) rupture of the eyeball, orbital fracture;
(3) fracture of maxillofacial and skull base.
7. Ultrasound findings:
(1) Emergency trauma seen in the abdominal cavity fluid, suspected rupture of internal organs such as the liver, spleen or kidneys and bleeding of critically ill patients;
(2) Acute cholecystitis considered gallbladder suppuration and acute perforation of the patient;
(3) Consideration of acute necrotizing pancreatitis;
(4) suspected rupture of ectopic pregnancy and intra-abdominal internal hemorrhage;
(5) late pregnancy with oligohydramnios and rapid fetal respiration and heart rate;
(6) cardiomegaly combined with acute heart failure;
(7) massive myocardial necrosis;
(8) massive pericardial effusion combined with pericardial tamponade.
(4) Pathology "critical value" items and the scope of the report:
1. Pathological findings of malignant lesions that the clinician failed to estimate.
2. Malignant tumors with positive margins.
3. The diagnosis on conventional sections is inconsistent with the diagnosis on frozen sections.
4. Inconsistency between the sent specimen and the sent list.
5. Rapid pathology special circumstances (such as the specimen is too large, too much material, or more than one frozen specimen at the same time, etc.), when the report time exceeds 30 minutes.
6. Frozen specimens sent to the examination of doubt or frozen results do not match the clinical diagnosis.