The hospital has 1080 beds and 24 wards. There are 528 nursing staff in the hospital, including 460 in-hospital nurses and 68 contract nurses. In addition, 182 rehabilitation assistants are recruited for the society to cooperate with the hospital's unaccompanied work. Among the 528 nurses, head nurse 1 person, 5 deputy head nurses, head nurse 122, nurse 195 and 205 nurses. In the nursing team, there are 33 undergraduate graduates, 48 undergraduate graduates, 87 junior college graduates1person, 69 secondary school graduates19/person. The nursing department is the organization and management organization of hospital nursing work, responsible for nursing quality, training and management of nursing staff, etc. And implement a three-level management network of nursing director, head nurse and head nurse. By revising the job responsibilities and workflow of nursing staff at all levels, various nursing systems, operating procedures, nursing quality standards, emergency procedures and rescue plans are formulated, so that the nursing management of the whole hospital runs on a standardized, standardized, procedural and systematic track.
In the nursing reform, the distribution center was re-established to be responsible for the inspection, medicine collection, material delivery, sewage collection and cleaning of all ward supply centers in the hospital. Disinfection supply center implements standardized management of the whole process from pollution to static; Implement network distribution of materials. Nurses input needed materials every day, which will be distributed by special personnel. Establish an intravenous drug preparation center to centrally allocate long-term clinical treatment;
Re-establish the process of taking medicine and leaving the hospital, which is convenient for patients to go through the discharge procedures.
Training of nursing talents
The introduction of competition mechanism and the implementation of competitive positions such as nurses on duty, general nurses and teachers can stimulate the working ability of personnel at all levels and reflect the value of nurses themselves. Strengthen the management of nurses with less than five years experience, formulate training manuals and technical files, and lay a good foundation for the establishment of nursing team. In order to meet the needs of hospital development, the knowledge structure of nursing team should be changed rapidly to improve the professional and technical level and ability of nursing staff. The nursing department conducts multi-channel and multi-form training for nurses at all levels, and carries out on-the-job nursing continuing education and professional skills training.
clinical care
Taking patients as the center and building a harmonious society with humanized service as the purpose, the nursing department started from me in the work of catering for inpatients and establishing unaccompanied wards in the hospital, led all nursing staff to carry forward their dedication and fully cooperated with the overall work of the hospital, ensuring the smooth completion of catering and unaccompanied work in nutrition package. The nursing department strives to improve the quality of nursing, constantly adjusts working procedures, ensures the safety of patients, insists on taking patients as the center and quality as the core, and pays attention to implementing psychological nursing and health education measures for patients. Nursing quality and service level have been greatly improved, and patients' satisfaction with nursing work has been rising.
The nursing department strengthens humanized service, further standardizes the process of patients' hospitalization, operation and taking medicine after discharge, and implements the escort of dead patients' remains, so as to truly think about what patients think and worry about what patients are anxious about. At the same time, strengthen patient satisfaction survey and put patients' opinions and suggestions in the first place.
Scientific research teaching
The nursing department attaches importance to clinical teaching and nursing scientific research management. 1958, has undertaken the teaching work of Tianjin Nursing School Branch, and then undertaken the undergraduate nursing teaching and clinical teaching work of Tianjin Medical University, Tianjin Higher Medical College and Armed Police Medical College. Over the years, a large number of outstanding nursing talents have been trained and transported for the nursing community in Tianjin.
The hospital has advanced equipment and excellent nursing talents. In 2003 and 2004 alone, nursing staff presided over and participated in 20 scientific research projects and new technologies at all levels, published 82 articles in various magazines at all levels, and participated in various academic conferences 2 1 1.
Looking ahead, there is a long way to go. All the staff of the nursing department will, as always, follow the tenet of "patient first, quality first", unite and cooperate, and strive to provide quality services for the clinical frontline with diligence, wisdom, sweat and love, with lofty aspirations and innovative spirit, and strive to create nursing quality and services suitable for modern hospitals at the grass-roots level, so as to fully promote the nursing work to a more brilliant tomorrow! Humanized service runs through the whole process of nursing work
By standardizing the patient's hospitalization process, the patient's operation process and the patient's taking medicine after discharge, it is convenient for the majority of patients, reduces the burden on their families, creates a good medical environment, and further guarantees the patient's medication safety. In order to reflect the whole care of patient culture, it is required that hospitalized patients be escorted to the morgue by medical staff after death.
Strengthen health education for patients.
Ensure the implementation of holistic nursing care for patients, implement gradual and systematic health education for patients, and implement the mode of initiative, participation and cooperation. Re-formulate the health education manual, including three parts: health education path, standardized health education plan and popular science knowledge. Unified health education record book, through health education assessment standards, monthly quality control to check the implementation of health education. Invite diabetes health education experts to train and guide nurses in the hospital and send nurses to study diabetes health education. Take a variety of health education methods for patients, including individual guidance, collective explanation, text propaganda, health exhibition, health broadcast and video, and use patients' activity time to carry out education.
Strengthen patient satisfaction survey
In order to provide patients with more enthusiastic and thoughtful nursing service, the nursing department attaches importance to patients' opinions and suggestions, strengthens nurse-patient communication, designs questionnaires, including outpatient questionnaire, transfer center questionnaire, operating room questionnaire, supply room questionnaire, nutrition catering staff questionnaire and rehabilitation assistant questionnaire, and conducts monthly summary analysis to find out deficiencies and defects, and timely corrects and improves them, thus ensuring the quality of nursing and establishing a good image of nurses in Tianjin Third Central Hospital. Standardize the work of disinfection supply center
Disinfection supply center is an important department to provide disinfection and sterilization items for clinical departments. The quality of its work is directly related to the quality of medical care and plays a vital role in preventing hospital infection.
The disinfection supply center * * * covers an area of about 1000 square meters. According to the article handling process, it is divided into contaminated area, clean area and sterile area. The disinfection supply center uses two automatic spray cleaners (Swiss) and three Shuang Ye pre-vacuum sterilizers as barriers to separate the three areas. The supply center also has 1 ethylene oxide sterilizer. The disinfection supply center implements computer network management, which greatly improves the work efficiency and accuracy.
In order to ensure clinical use, the disinfection supply center implements standardized management in the whole process from pollution to purification, ensures the quality of sterile articles, strictly manages the delivery and receipt of articles to clean vehicles, and prevents nosocomial infection. In order to reduce the burden on clinical nurses, the Disinfection Supply Center has taken over a lot of work, such as the unified cleaning of small towels, and gradually took over many items originally scrubbed by clinical nurses, and properly packed them, so that clinical nurses can return more time to patients and ensure the quality of care. The specifications of various dressing packages are increased at any time according to clinical needs, which embodies the purpose of serving the clinic. The Sterilization Supply Center has also strengthened the unified management of disposable sterile items to ensure the quality of sterile items and the quality of clinical care.
Reorganize transportation center
In order to return time to nurses, nurses to patients and make full use of nurses' time to take care of patients, the distribution center was re-established. The transfer center is mainly responsible for escorting patients to do various examinations, collecting all kinds of medicines, sending all kinds of specimens for inspection, collecting all kinds of materials for clinical use and transmitting all kinds of documents. The specific division of labor is to arrange the size of the area that the staff is responsible for according to the nature of the department. Departments with small workload are responsible for every 4-7 departments 1 person; For departments with heavy workload, every two departments are responsible for 1 person, especially after the cancellation of family companionship, the workload increases, and every four departments increase 1 person. This arrangement not only meets the needs of clinical departments, but also ensures the safety of patients, shortens the waiting time and achieves patient satisfaction. At the same time, strengthen the quality control management of the delivery center, and strengthen the assessment of staff through the evaluation of head nurses and patients.
Reform the management mode of cotton products
In order to reduce the burden of clinical nurses and make them have more time to care for patients, the management mode of cotton products was reformed. It changed the situation that nurses counted clothes in the ward corridor in the past. Cotton goods are no longer stored and kept in the ward, and all clothes are stored in the laundry room. Laundry staff go to various departments to collect dirty sheets on time every day and deliver clean sheets, which not only avoids the pollution of dirty sheets to the ward environment, but also saves the time for nurses to count clothes. On this basis, the nursing department unified the time for changing bedding in all wards of the hospital, and the laundry room sent the required sheets to all wards one day in advance to ensure that every patient could change into new bedding, thus ensuring the quality of clinical nursing.
Realize the computer network distribution of materials
Hospital computer network system is used to realize the network management of disposable articles and sterile articles in material distribution and disinfection supply center. It has changed the phenomenon that nurses need to receive a large amount of materials at one time every week. Every day, each ward needs a fixed amount of materials according to the calculation. After counting the materials every day, the nursing staff will input the number of materials needed for that day into the computer before 9 am. After confirmation, ministry of materials and equipment will allocate materials for each ward, which will be sent to each ward by the distribution center and signed by both parties. This not only saves human resources, but also improves work efficiency, saves nurses' time, and enables nurses to devote more energy to the comprehensive care of patients, so that patients can get physical and psychological holistic care.
Implement the configuration of intravenous liquid medicine center
Ensure medical safety and reduce the workload of clinical nurses, and implement unified liquid preparation in the liquid preparation center of the pilot ward. Configuration of commonly used drugs, nutrition, antibiotics and cytotoxic drugs for intravenous drip in inpatient wards. Meet the daily ration 1600 bags, and consider the allowance. The establishment of intravenous liquid dispensing center not only saves the dispensing time of clinical nurses and reduces the workload,
And standardize clinical medication, pharmacists participate in trials, and timely adjust irrational drug use. Prepare the liquid in a clean environment, reduce the chance of pollution in operation, increase the number of inspections, reduce the occurrence of errors, and unify the labels to make them more standardized.
Establish a reporting system for critically ill patients.
Strengthen the management of critically ill patients, ensure the quality of nursing, establish a reporting system for critically ill patients, and implement in-hospital nursing consultation. For critically ill patients in this department, if there are unresolved nursing problems and need the assistance of other departments or departments, the head nurse of the ward shall apply to the nursing department, which shall organize, coordinate and determine the consultation time, place and personnel who will participate in the nursing consultation. Please discuss the problems that should be paid attention to in the nursing process and the relevant nursing measures that should be taken, discuss the corresponding nursing measures that need to be taken to solve the nursing problems, and make a nursing plan.
Standardize all routine nursing operations.
In order to improve the technical operation level of nursing staff, standardize nursing operation procedures and ensure the quality of nursing work, the nursing department unified the common clinical nursing operations. After repeated revision, standardization and formulation of operating procedures, the standardized content was finally included in the nursing theory examination of the whole hospital by shooting videos, engraving CDs and rolling them in the whole hospital. Unify the steps of cardiopulmonary resuscitation, hold the first aid knowledge training of cardiopulmonary resuscitation, and plan the rescue on the spot.
Improve various rules and regulations
Implement more standardized, standardized and programmed nursing management, and unify the ward system, job responsibilities, workflow and layout facilities, including the unified layout of nursing stations, treatment rooms, auxiliary treatment rooms, wards, intensive care units, sewage rooms, various goods cabinets, treatment vehicles and rescue vehicles. On this basis, further standardize all kinds of record books, such as ICU patient register, rescue vehicle receiving book, rescue vehicle receiving book and so on. The nursing department issues unified standard samples for all standard contents, and at the same time, in order to further strengthen management, it assigns personnel to each ward to check the implementation of various systems.
Standardize nursing rounds
According to the annual plan, the nursing department regularly participates in ward rounds, critical cases and death cases, finds and solves problems in nursing work in time, and takes measures to improve nursing quality and avoid defects.
Complete the comprehensive quality rounds of the director of nursing department 4 times a year, and the nursing department participates in the self-examination room of the department for more than 20 times.
The comprehensive quality rounds of nursing department are carried out four times a year, each quarter 1 time. All kinds of rounds required to be attended by the nursing department are recorded and comprehensively evaluated. Rounds of comprehensive nursing quality can be conducted in various forms, such as demonstrations, slides and models. Each department conducts monthly rounds of cases, critical cases and deaths, and makes records, analyzes and discusses the existing or potential problems in nursing, and learns from each other to improve the quality of nursing.
Standardize the writing of nursing documents
The nursing department standardized the writing of general nursing records according to the requirements of nursing quality control, and further adjusted the ICU critical nursing records according to the needs of clinical implementation. Before writing ordinary care records in each ward, two head nurses were sent out to study, and a pilot ward for writing ordinary care records was established. Then, according to the characteristics of diseases in each system, the writing norms and requirements of gynecological internal and external systems are formulated, and the design log is constantly revised and improved according to the actual situation. On this basis, standard samples of ordinary care records were made and distributed to all wards. Strengthen the management of nurses under five years.
In order to adapt to the new situation of hospital reform, strengthen the basic construction of nursing team and comprehensively improve the overall quality of young nurses. The nursing department adopts the principles of fairness, justice and openness, and conducts comprehensive assessment on junior nurses through comprehensive assessment. For those who fail the examination, the probation period will be extended, or even terminated or transferred from their posts. The nursing department strictly implements the rotation plan and assessment standards for nurses with less than five years of service, and establishes assessment files. The Training Manual for Junior Nurses clearly puts forward the basic tasks and codes, specific requirements and performance evaluation standards, and makes detailed plans for the records of basic technical operation, specialist technical operation, holistic nursing and business learning, laying a good foundation for the training and evaluation work in the next year.
Competing for general nurses and establishing first aid teams.
The nursing department openly competes for the appointment of general nurses for nurses with 3-8 years' experience in the whole hospital, and sets up a first aid team. Through comprehensive assessment, 15 nurses stood out, and they gloriously became the first batch of general nurses in the Third Hospital of the City. The nursing department held a forum to understand the actual needs of each general nurse and make detailed training plans and study arrangements for them. The nursing department aims to alleviate the contradiction between the heavy nursing work and the shortage of nursing staff during the peak period of ward patients through the training of general nurses, so that nurses have enough time to care for each patient. It can also provide more development space for more outstanding young nursing backbones, create more learning opportunities, give play to the enthusiasm of nursing staff at all levels, and build a platform for the echelon construction of nursing management talents.
Strengthen three-level technical management
In order to fully mobilize the enthusiasm of each nurse, promote the overall nursing work to develop in depth, and facilitate the hierarchical use and training of nursing talents, a three-level technical nurse competition was implemented. Before the competition, the nursing department specially organized a mobilization meeting for nurses in the whole hospital. Determine the conditions for competitive recruitment. Those who meet the requirements voluntarily register. After passing the theoretical examination and clinical practice ability examination, 7 1 nurses were screened and competed for posts. After the competition, the nursing department also held a seminar to solicit the opinions and suggestions of nurses and the requirements for training, and the nursing department conducted systematic training for them.
Strengthen the management of contract nurses
Systematic training, assessment and management of contract nurses. Distribute training manuals for contract nurses and make training plans, including theoretical knowledge and operational skills training. Each training content is divided into theoretical explanation and teaching. After the training, the nursing work can be undertaken only after passing the examination.