Measures to prevent medical errors

In order to improve the quality of care and prevent the occurrence of errors and accidents, our hospital department has developed a series of preventive measures with satisfactory results. Now the experience is reported as follows. 1 Strict implementation of the checking system 1.1 Patient checking When picking up the patient in the ward, according to the surgical notification form, the patient's medical record should be carefully checked, checking the patient's name, gender, bed number, hospitalization number, diagnosis, name of the surgery and surgical site, sending the patient into the prescribed surgical suite and carefully checking the patient's name, hospitalization number, and surgical site, etc., by the roving nurse of this surgical suite, anesthesiologists, and the surgeon, confirming that there is no error before Anesthesia and surgery shall be performed only after confirming that there is no error. 1.2 Checking the surgical site and reasonably placing the body position To ensure the accuracy of the site, ask the patient about the lesion site and check the relevant information such as medical records, surgical lists and X-rays, check the surgical site with the anesthesiologist before the operation, and check with the operator again after placing the body position before the operation. When placing the surgical position, it is necessary to ensure the safety and comfort of the patients and avoid the damage of blood vessels, nerves and muscles, especially the prone to accidental injury surgical position such as prone position, amputation position and lateral position, etc. More attention should be paid to them. 1.3 The checking of surgical items Before the operation, the hand-washing nurse and the roving nurse*** count the number of instruments, gauze, suture needles, gauze pads, etc. and record them. During the operation, keep the field clean, place the instruments in an orderly manner, retrieve them in time after use, and when the operation requires temporary increase of items, they must be checked and recorded in time. Before closing the body cavity, the hand-washing nurse should check the accuracy with the roving nurse before closing. After closing, the two check the number again. 1.4 Resuscitation of the patient drug check intraoperative resuscitation of patients, the nurse should be familiar with the role of the palm of the drug, dosage, usage, adverse reactions and contraindications, etc., in order to cooperate with the resuscitation. The implementation of oral medical advice should be repeated to the doctor, confirm the correctness of the implementation of the empty ampoule retained after salvage check again, make up the doctor's orders in a timely manner, the operation is completed, can be discarded. 1.5 Prevent the loss or mixing of pathological specimens Specimens are an important basis for the diagnosis and treatment of patients. Proper preservation and handling of specimens is particularly important [1]. Pathology specimens need to be labeled, pay attention to the patient's name, bed number, the name of the pathology specimen, together with the pathology sheet according to the designated location of the storage, by the person who sends the examination. Frozen section specimens in the water immediately after removal into the prepared specimen bag, labeled, noting the patient's name, bed number, specimen name, take the specimen site, by a person immediately together with the pathology checklist sent to the Department of Pathology for examination. If more specimens are taken, the specimens should be arranged in order, labeled and checked with the doctor***, and should not be mixed. 1.6 Prevent wrong blood transfusion Blood transfusion should be carefully checked the patient's name, hospitalization number, blood type 3 times, the blood collector in the blood bank to 1 time, the anesthesiologist and the circuit nurse to 1 time, the transfusion of the need for blood or blood adders to 1 time. The blood collector can only collect the blood needed by one patient at a time. Blood transfusion needs two people **** the same check and sign, closely observe the transfusion reaction [2]. 1.7 Prevention of electrical burns Before using high-frequency power to check whether the instrument performance is good, the negative plate is placed in the patient's plump place in close contact with the skin, generally the first thigh, calf or buttocks, the operation to prevent dislocation of the negative pole, displacement, to avoid burns to the patient. Those who have a pacemaker, generally do not use high-frequency electric knife to avoid accidents, avoid contact with the metal part of the operating bed, and the limbs are wrapped with bed sheets to prevent burns. 1.8 Prevent incision infection Strengthen air disinfection monitoring, turn on the laminar flow air purification system 30 min before surgery, and strictly control the number of people entering the operating room to minimize the flow of people. Strictly divide the sterile surgery and infected surgery, and the infected surgery personnel can't go to other operating rooms or visit the surgery at will to prevent cross-infection. Strictly aseptic operation during surgery, strengthen the concept of asepsis. 2 Retain the evidence related to the reversal of the burden of proof 2.1 Retain the nursing record sheet Nursing record sheet as a medical legal documents, is the "reversal of the burden of proof" is one of the important evidence. Nurses should objectively and truthfully fill in the record sheet about the patient's situation, including the patient's general condition and the items brought, the time of admission to the room, the surgical position, surgical style, anesthesia and mode of operation, intraoperative transfusion, transfusion, specimens, the number of articles, skin conditions, the use of tourniquet pressure time, etc., requiring standardized writing, not to be altered, and the nurse's signature in the inventory after the end of the operation. 2.2 Records of sterilization effect monitoring are kept for the record, including sterile items, autoclaved items, and sterilization monitoring of abdominal instruments. Sterilization markings for surgical supplies and human implants are affixed to the medical record and nursing record book respectively to prevent disputes. 3 Other Factors Preventing Disputes 3.1 Medical Fees Reasonable fees are charged according to the surgical situation, and the use of valuable medicines, special materials and instruments should be agreed and signed by the patients themselves. 3.2 Pay attention to unity and cooperation The operating room should work in unity and cooperation with many departments, and should not shift the responsibility to each other, so as to avoid unnecessary troubles or disputes, and should not talk about topics unrelated to the operation during the operation. 3.3 Reasonable arrangement of human resources according to the size of the surgery to the nursing staff's ability, professional characteristics, the arrangement of work, to achieve complementary advantages, a clear division of labor, the responsibility to a person

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