Question 1: medical safety adverse events include what adverse events The Ministry of Health will be divided into four categories of medical adverse events: one category for the warning event, refers to the patient's unanticipated death, or the natural progression of non-disease process resulting in permanent loss of function. The second category is an adverse event, which refers to the damage to the patient's organism and function caused by the diagnostic and therapeutic activities rather than the disease itself during the medical treatment of the disease. The third category is a non-consequential event, which, despite the fact that an error occurred, did not cause any damage to the patient's organism and function, or had minor consequences that could be fully recovered from without any treatment. The fourth is a hidden event, due to the timely detection of the error, which did not form a fact.
Combined with the actual situation of China's current hospitals, in accordance with the SH9 classification of adverse events into four more reasonable, medical adverse events SH9 classification refers to the presence or absence of the fact of fault, whether or not to produce the consequences of the current classification of medical adverse events as the principle of the classification of the current medical adverse events, suitable for the current medical adverse events of a classification method.
Level I - there is a fact of fault and consequences, if there is a causal relationship between the two, according to the severity of the consequences constitute a "medical incident" or "medical error. Example: the patient Wang íí because of his condition to íí hospital emergency department, because the hospital beds are full of patients can not be admitted, the receiving physician will be informed of the situation and recommended referral, but no timely diagnosis and treatment of the patient and actively follow up, did not ask for specialist consultation, did not ask for advice from the supervisor of the physician, director of the department in a timely manner, but also did not report to the relevant departments for coordination of the beds. The patient's condition deteriorated dramatically and he died.
II level - no fault fact but caused the consequences of the incident: medical behavior without fault, mainly
Medical accidents caused by drugs, medical devices, implants, etc., or unavoidable medical complications and the natural regression of the disease, the consequences of which may be more serious, but does not generally constitute "Medical malpractice" or "medical error". Example: a patient due to "prostate hyperplasia" in the íí hospital for prostate surgery, the use of post-operative hemostatic drugs triggered the patient's acute cerebral infarction.
III - the fact that there is a fault but did not cause the consequences of the incident: although the occurrence of the wrong
fact (refers to the wrong behavior has been carried out on the patient), but did not cause any damage to the patient's body and function or have minor consequences, without any treatment can be fully recovered. Example: a delay in the specimen delivery process that did not affect the test result event.
Level IV - no fault facts and consequences of the event: due to the timely detection of errors
Errors, did not form the fact of fault of medical behavior, the level of its lowest. Example: the patient Huang í in 2012 í month í hospitalized for examination and treatment, the Department of Laboratory in the afternoon of the second day of admission to the hospital issued a test report for the "B" blood type. Hospitalized the next day night due to the patient's surgical need for blood transfusion, the surgeon issued a blood transfusion order and application form (2 units of red blood cells, plasma 2000 ml), the application form records blood type "B", the blood bank blood type checking found that the patient's blood type is "O", the review was determined to be "O". After double checking, the patient's blood type was determined to be "O", so the patient was allocated "O" blood; the nurse in the operating room checked the patient's blood before transfusion and found that the test report form did not match the blood type of the marker in the blood bag, and did not use the patient's blood, so she sent the feedback to the blood bank, and then the blood bank confirmed the patient's blood type to be "O" again. The patient's blood type was confirmed to be "O" by the blood bank, and the transfusion was carried out without any error.
Question 2: What are the contents of the quality and safety management of healthcare meeting topics, participants, what problems are found, what measures are given, the development of plans (PDCA methodology), by what people are responsible for and the specific division of labor, and in what time to complete, to achieve what goals, and so on
Quality and safety management of healthcare questions, what are the hidden medical safety hazards, urgent, thank you .1 Medical personnel lead to safety hazards
The causes of medical errors and accidents are mainly from the human factor, there are four main aspects.
1.1.1 Sense of mission and responsibility is not strong
A few medical personnel lack of a sense of mission to save lives and help the injured, no sense of enterprise and work responsibility, negligence and carelessness in the work, the performance of their duties is not conscientious, the implementation of the rules and regulations and medical operating procedures are not rigorous, AWOL, diagnosis and treatment is not serious, the inspection and observation of the patient is not meticulous, the disposal of the treatment in a timely manner resulting in the aggravation of patients' condition and the The damage to the organism.
1.1.2 Poor sense of responsibility for safety, lax implementation of the system
In recent years, although the hospital has formulated a series of rules and regulations in the area of safety management, but the implementation of many core systems of medical safety is lax. For example, the first medical responsibility system, three-level physician room system, difficult case discussion system, consultation system, critical patient rescue system, and so on, which in turn led to the occurrence of medical errors and accidents.
1.1.3 Insufficient motivation to study the business, the technical level is not high
Medicine is a comprehensive, practical science, the knowledge of the rapid update, requiring medical personnel to continue to learn and summarize, both solid medical theory and superb clinical operation technology. However, a few medical personnel learning business is not serious, do not seek progress, sloppy work, encountered difficult problems both do not consult the information, and shy to consult others, the technical level is not high, resulting in patients misdiagnosis and misdiagnosis.
1.1.4 The concept of "people-oriented" is weak, and patient communication is not in place
Patients need to be cared for when receiving medical services, to be respected, to be accepted, to understand his condition and diagnosis and treatment programs, to feel safe and eager to get well soon. This requires serious communication and explanation of medical staff, but a few medical staff "patient-oriented" concept is weak, self-centered, lack of basic quality of the patient's responsibility, communication awareness is not strong, the attitude is not positive, the way inappropriate, the explanation is not in place, the content of the patient should know not seriously mission, the patient should not know the content of the arbitrary nonsense, and some of the content of the patient should not know The content of the random nonsense, there are medical personnel service consciousness fade, hard words, rude attitude, and triggered the patient's resentment, suspicion and take a non-cooperative attitude, which can easily lead to the occurrence of doctor-patient conflicts.
1.2 Medical equipment safety hazards
There are three main aspects of the performance: First, improper use of medical equipment to bring the hidden danger. Mainly manifested in the use of instruments and equipment is not in strict accordance with the operating procedures, did not make the necessary adjustments and inspections, so that the equipment electrical safety, mechanical safety, physical safety and other risks are controlled in an acceptable range, otherwise it will bring serious harm to the patient. According to the survey, in the application of emergency equipment, the failure rate of equipment due to improper operation of the medical staff itself accounts for 60% to 70%. The resulting physical damage to the patient also occurs frequently. Secondly, the hidden danger of poor maintenance. Medical instruments in the use of the process requires regular maintenance, but the instrument maintenance technology is insufficient, the level is low. According to statistics, about 30% of the medical equipment "with disease" work, increasing the medical risk. Thirdly, the safety index of medical devices is not clear. Such as protection against grounding, leakage, electric shock and so on. Exceeding the standard value of energy is easy to patients and operators to bring the potential danger of not easy to detect.
1.3 Safety hazards in the management of drugs
With the gradual improvement of China's drug standards, the requirements for the storage conditions of drugs are also getting higher and higher. Sunlight, air, humidity, time are important factors affecting the quality of drugs, drugs due to improper storage, not only lead to reduced efficacy, but also make the drug toxic side effects increase. Some drugs need to be stored under refrigerated conditions, in the high temperature season, such as not taking the necessary refrigeration measures, can lead to drug deterioration. Such as vitamin C, vitamin K1 is easy to decompose and discoloration, the effect is reduced, A.P.C deliquescence increase gastrointestinal *** sex, cod liver oil oxidation toxicity, etc.. This is also a safety hazard of drugs. In the rational use of drugs still exists "on paper" phenomenon. Compounding contraindications unreasonable use of drugs in the prescription of a certain proportion, resulting in a decrease in drug safety; according to statistics, the hospital's antibiotic use rate of more than 50%, indicating the existence of the phenomenon of abuse of antibiotics. In addition, there are loopholes in the management of expired drugs. Especially some infrequently used emergency medicines, often appear expired phenomenon, is a major hidden danger of drug safety.
1.4 Medical management of the existence of security risks
1.4.1 The management of the troops wounded and sick have certain difficulties
The reason is that most of the troops wounded and sick young, light condition, while the psychological pressure and the burden of thought is heavy, there are a small number of grass-roots troops to the ideological mood of the heavy, mild condition, difficult to manage the soldiers sent to the hospital hospitalization in order to manage the medical, plus ...... >>
Question 4: What are the main contents of the enterprise safety inspection Only for reference:
A, the main contents of the daily safety inspection 1, the implementation of the safety responsibility system of personnel at all levels;
2, safety activities (pre-shift meeting, KYT, weekly safety meeting, etc.) to carry out the implementation of the situation;
3, safety Rules and regulations, the implementation of measures;
4, on-site safety management (operating environment, safety equipment and facilities set up; work site hidden dangers and rectification; equipment guards, regular maintenance, inspection and maintenance; special equipment and safety accessories inspection; fixed-position management);
5, employee compliance (labor) The use of protective equipment; work, operating methods; safety regulations implementation; hazard foreknowledge, identification); 6, employee safety regulations and general knowledge of safety;
Two, the main contents of a comprehensive safety inspection 1, the operation of the site hidden dangers; 2, the control of sources of danger; 3, the implementation of the system of responsibility for production safety; 4, the implementation of safety rules and regulations 5, site safety management; 6, employee compliance; 7, wearing of labor protection equipment. 8, the implementation of other temporary work.
Question 5: What is non-medical safety in hospitals:What does non-medical safety include Don't understand?
Question six: medical safety Hidden dangers are those Medical hidden dangers are as follows:
1. Individual departments of medical documents are not standardized writing, mainly because of the scribbling of the handwriting is not easy to recognize.
2. Individual outpatient clinics do not write outpatient medical records in accordance with the regulations, the content is too simple.
3. Certain medical personnel do not pay attention to medical safety, lack of awareness of the current medical environment, and lack of communication with patients, so that they cannot protect themselves well.
4. There are deficiencies in the writing of medical prescriptions.
Question 7: What systems are included in the eighteen core systems of medical quality and safety 1. First diagnosis is responsible for the system
In order to effectively carry out the hospital's duty 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 formulated:
(a) due to a variety of reasons or diseases leading to the patient's vital signs of a serious (a) due to various reasons or diseases that cause the patient's vital signs to appear serious morbid, threatening the patient's life, or in the process of treatment there may be accidents and complications threatening the patient's life is regarded as a critically ill patient.
(2) Critically ill patients are responsible for the first diagnosis, the first physician and medical department must be responsible for the patient's first aid and maintenance of vital signs until the implementation of a specialized medical department and physicians for 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 the hospital to deal with critical 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 immediately report 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 as a liability event, the hospital will be severely punished, and the consequences arising from this, the person 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 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 on the patient temporarily.
(3) Before checking the room, medical staff should do a good job of preparation, such as medical records, X-ray films, all the 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 weekly nursing check-up, 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 treatment process should pay attention to four aspects of the content of the difficult cases should be mentioned clinical symptoms, signs, laboratory results in the differential diagnosis of the significance of the diagnosis and clear diagnosis of the pathway, measures and methods: for patients who have been issued a "critical" notice, should be
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 the newly admitted, critical, diagnosis is not clear, the treatment effect of bad patients to focus on the inspection and discussion, listen to physicians and nurses reflect, listen to the patient's statement, checking the disease ....... >>
Question 8: What is the difference between quality of care and safety of care? Medical quality:
Narrow perspective, mainly refers to the timeliness, effectiveness and safety of medical services, also known as the quality of diagnosis and treatment; broad perspective, it not only covers the content of the quality of diagnosis and treatment, but also emphasizes the patient's satisfaction, the efficiency of medical work, the economic effect of medical technology (the relationship between input and output), as well as the continuity of medical care and systematic, also known as the quality of hospital (medical) services.
Medical safety refers to the hospital in the implementation of health care process, the patient does not occur outside the scope of the laws and regulations allow psychological, organic structure or function damage, impairment, defects or death. Its core is the quality of medical care. Medical safety is a cause and effect relationship, medical safety directly affects the social and economic benefits. Unsafe medical treatment will lead to prolonged patient's illness and treatment method complexity and other consequences, not only increase the medical cost and economic burden, and sometimes lead to medical accidents caused by disputes, affecting the hospital's social credibility and image.
Question 9: quality management system for medical safety I. Put medical quality in the first place, the quality management into the work of the hospital. Second, the establishment of a sound quality assurance system, the establishment of quality management organization, with special *** personnel, responsible for quality management. Third, the quality management organization should be based on the relevant requirements of the higher level and the actuality of their own medical work, the establishment of practical quality management program. Fourth, the main content of the quality management program includes: the establishment of quality management objectives, indicators, plans, measures, evaluation and information feedback. V. Strengthen the quality management education for all staff and organize their participation in quality management activities. Sixth, quality management work should be recorded in writing, and the quality management organization to form a report, and regularly reported to the next level. Seven, a quarterly quality inspection, section of a monthly quality inspection, the results of quality inspection and merit awards and penalties combined with post stickers linked to the review.